Educational Exhibit Abstract No. 273 - Optimizing practice standards to reduce interventional radiology physician radiation exposure

Abstract

Learning Objectives To evaluate causes of and decrease level of physician exposure to excess radiation. Background Subjects included in the study were 6 attending physicians and 3 fellows at a single university hospital. Deep, eye and shallow exposure to radiation were measured. Baseline data was acquired retroactively for a period of one year. As an intervention starting 7/1/12 the IR division instituted required use of all leaded equipment, in-room shields, and reduction of fluoroscopy pulse rate. The goal is to reach an exposure average below ALARA I for each quarter. Resulting measurements were followed quarterly thereafter to determine differences in exposure. Clinical Findings/Procedure Details Baseline data showed that these physicians exceeded ALARA I levels 55.6% of quarters for deep exposure. Eye exposure exceeded ALARA I 58.3% of the quarters. Additionally, ALARA II was exceeded for deep and eye exposure 11.1% and 13.9% of quarters, respectively. The division averaged over ALARA I for both deep and eye exposure throughout the year. The first experimental quarter shows that there was a decrease in exposure when comparing the same quarter from 2011. The 2012 data for deep, eye and shallow exposure averaged 136.0, 475.6 and 484.2mRem per physician, respectively. Deep and eye exposure averaged below ALARA I for the department. The 2011 exposure rates for the analogous quarter for deep, eye and shallow exposure averaged 271.5, 906.0 and 889.4mRem, respectively. The difference between 2011 and 2012 showed a trend toward improvement but did not reach a level of statistical significance (p=0.076). Further, comparing this experimental quarter to the overall quarterly average from the baseline year, the difference was not statistically significant (p=0.077). Conclusion and/or Teaching Points Exposure to interventional radiologists has been reduced since instituting the outlined interventions. However, the intervention has not yet reached a level of significance. The intervention will be continued to see if significance can be reached in the following quarters since a strong positive trend in radiation exposure reduction has been observed.