The effect of fellows' training in invasive cardiology on radiological exposure of patients

Abstract

The aim of this work was to evaluate and quantify the impact of an invasive training of cardiology fellows on some exposure parameters. From 1 January 2000 to 31 December 2002, three staff members performed 2.582 diagnostic procedures (Group 1) that were compared with 819 performed by, or with the participation of five cardiology fellows (Group 2). Exposure parameters were as follows (Group 1/Group 2): fluoroscopy time 3.8 +/- 4.5/5.5 +/- 5.9 min (+38%), mean number of frames 589 +/- 282/642 +/- 260 (+9%), Kerma-area product (KAP) during fluoroscopy 10.6 +/- 14/15.5 +/- 16 Gycm2 (+45%), KAP during cine-angiography 20.8 +/- 14/22.5 +/- 12 (+8%), total KAP 31.5 +/- 28/38.1 +/- 28 (+21%). Differences were all significant (P <or= 0.001 for all comparisons). For individual fellows, a trend towards reduction of exposure parameters was seen over time, but only KAP(cine) was significant (25.7 +/- 14/22.2 +/- 11 Gycm2, P <or= 0.001). In conclusion, all parameters measured in this study increased significantly in diagnostic procedures performed with fellows when compared with staff members alone, fluoroscopy time and the related KAP in particular. Careful supervision limited these increases so that exposures remained within acceptable limits.