Effect of the learning process on procedure times and radiation exposure for CT fluoroscopy-guided percutaneous biopsy procedures.
OBJECTIVE
To assess if the learning process associated with computed tomography fluoroscopy (CTF) technology influences procedure and fluoroscopy times for percutaneous biopsy procedures.


METHODS
Prospective analysis of the initial 250 consecutive patients who underwent percutaneous biopsy with use of a CT scanner equipped with rapid image reconstruction and fluoroscopic capabilities in a 24-month period. All procedures were performed with both continuous and spot fluoroscopic technique, with typical radiation parameters of 50 mA, 120 kV, and a 10-mm-slice thickness. The procedures were all performed by a single experienced interventional radiologist to limit the variables of physician expertise, interventional materials used, and biopsy approach. The subject group was divided into five equal consecutive groups of 50 patients. In each subgroup, the authors recorded mean lesion size, success, and complication rates, as well as mean procedure and fluoroscopy times.


RESULTS
The five subgroups were similar patient populations as documented by the absence of statistically significant differences when comparing mean lesion size, procedure success, and complication rates (P > .05; ANOVA test). A statistically significant decrease in mean fluoroscopy (groups 1-5: 50.26 vs 45.24 vs 33.86 vs 32.68 vs 25.8 sec/patient) and mean procedure times (groups 1-5: 30.08 vs 27.9 vs 26.34 vs 25.6 vs 21.6 min/patient) was recorded between the patient subgroups (P < .0001; ANOVA test).


CONCLUSIONS
The learning process associated with CTF technology impacts procedure parameters by decreasing both mean procedure and fluoroscopy times, thereby increasing patient turnover and decreasing radiation exposure to the patient and the operator.
Gianfelice
D
D
Department of Diagnostic Radiology, Centre hospitalier de l'Université de Montréal, Hôpital Saint-Luc, Quebec, Canada. gigi127@aol.com
Lepanto
L
L
Perreault
P
P
Chartrand-Lefebvre
C
C
Milette
P C
PC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001706:Biopsy / Q000379:methods*; D002983:Clinical Competence; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D007858:Learning; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D011446:Prospective Studies; D015642:Radiology, Interventional / Q000193:education* / Q000295:instrumentation; D011874:Radiometry; D013997:Time Factors; D014057:Tomography, X-Ray Computed