2:34 PM Abstract No. 147 - Development and application of a radiation dose passport in interventional radiology

Abstract

Purpose The purpose of this study was twofold 1)create a software application that could provide a patient radiation dose history (IR and CT exams)prior to any interventional procedure 2)measure the impact of this information on radiation dose. Materials and Methods A software application was built which could access all available radiation dose information from the EMR and RIS, then create a report including previous IR and CT exams. To minimize workflow interruption, this was launched via a web link that was placed on the desktop adjacent to every procedure room. The study included all potentially high dose IR cases. Prior to performing a case, the MD logged into the system and 50% of the time would be provided the radiation dose passport. If the MD received the dose passport, they were later sent an email questionnaire to determine the subjective value of the information. Comparison of case cohorts and patient radiation dose between instances when the IR MD received or did not receive the information provided objective value and impact of the IR radiation dose passport. Results Over 8 months there were 140 procedures performed as part of the study for which dose information was available. The most common was embolization (n=59). In 3% of cases, the MD changed their procedure based on receiving the dose passport. There was no statistically significant difference between the dose used for similar cases, whether the IR MD received or did not receive the IR radiation dose passport (mean without dose passport=951mGy, mean with dose passport=968mGy). Conclusion Providing IR MDs information about the amount of radiation dose a patient had previously received had little impact on the current procedure. This is most likely because the majority of patients undergoing complex interventional procedures who qualified for our study had advanced cancer. Given their prognosis, the risk/benefit is such that performing the procedure,regardless of the dose, was more important that the remote possibility of a skin injury or radiation induced neoplasm. However, the IR dose passport may provide more value in a practice with a different patient mix, perhaps where children or benign conditions (e.g. UAE) are more commonly treated.