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13-02-2024 | Ionizing Radiation | Original Article

Radiation dose reduction during venous access port implantation: the importance of upgrading equipment and radiation-protection training

Authors: Delphine Vallot, Ana Cavillon, Amélie Lusque, Philippe Izard, Geneviève Salvignol, Bertrand Delpuech, Régis Fuzier

Published in: Irish Journal of Medical Science (1971 -) | Issue 3/2024

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Abstract

Background

Implantable central venous port systems are widely used in oncology. We upgraded our fluoroscopy machines, and all anesthetists completed two training courses focusing on the risks of ionizing radiation for patients and health workers.

Aims

This study aimed to evaluate the impact of upgrading the machines and the radiation-protection training on ionizing radiation exposure during venous port system implantation.

Methods

We retrospectively analyzed consecutive venous port implantations between 2019 and 2022. The older fluoroscopy machines were replaced by two new machines. A first training session about health worker radioprotection was organized. The medical staff completed a second training course focused on protecting patients from ionizing radiation. We defined four distinct time intervals (TI): venous port implantations performed with the old equipment, the new fluoroscopy machines, after the first training course, and after the second training course. The air kerma-area product (KAP) was compared between these four TI and fluoroscopy times and the number of exposures only with the new machines.

Results

We analyzed 2587 procedures. A 93% decrease in the median KAP between the first and last TI was noted (median KAP = 323.0 mGy.cm2 vs. 24.0 mGy.cm2, p < 0.0001). A decrease in the KAP was observed for each of the 11 anesthetists. We also noted a significant decrease in the time of fluoroscopy and the number of exposures.

Conclusions

Upgrading the fluoroscopy equipment and completing two dedicated training courses allowed for a drastic decrease patient exposure to ionizing radiation during venous access port implantation by non-radiologist practitioners.
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Literature
1.
go back to reference Council Directive 2013/59/Euratom of 5 December 2013 laying down basic safety standards for protection against the dangers arising from exposure to ionising radiation, and repealing Directives 89/618/Euratom, 90/641/Euratom, 96/29/Euratom, 97/43/Euratom and 2003/122/Euratom (2013) https://eur-lex.europa.eu/eli/dir/2013/59/oj Council Directive 2013/59/Euratom of 5 December 2013 laying down basic safety standards for protection against the dangers arising from exposure to ionising radiation, and repealing Directives 89/618/Euratom, 90/641/Euratom, 96/29/Euratom, 97/43/Euratom and 2003/122/Euratom (2013) https://​eur-lex.​europa.​eu/​eli/​dir/​2013/​59/​oj
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go back to reference Greffier J, Etard C, Mares O et al (2019) Patient dose reference levels in surgery: a multicenter study. Eur Radiol 29:674–681CrossRefPubMed Greffier J, Etard C, Mares O et al (2019) Patient dose reference levels in surgery: a multicenter study. Eur Radiol 29:674–681CrossRefPubMed
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go back to reference Jonczyk M, Gebauer B, Rotzinger R et al (2018) Totally implantable central venous port catheters: radiation exposure as a function of puncture site and operator experience. In Vivo 32:179–184PubMedPubMedCentral Jonczyk M, Gebauer B, Rotzinger R et al (2018) Totally implantable central venous port catheters: radiation exposure as a function of puncture site and operator experience. In Vivo 32:179–184PubMedPubMedCentral
Metadata
Title
Radiation dose reduction during venous access port implantation: the importance of upgrading equipment and radiation-protection training
Authors
Delphine Vallot
Ana Cavillon
Amélie Lusque
Philippe Izard
Geneviève Salvignol
Bertrand Delpuech
Régis Fuzier
Publication date
13-02-2024
Publisher
Springer International Publishing
Published in
Irish Journal of Medical Science (1971 -) / Issue 3/2024
Print ISSN: 0021-1265
Electronic ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-024-03623-7

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