title: Coaching Reduced the Radiation Dose of Pain Physicians by Half during Interventional Procedures.
abstract: The increased use of C-arm fluoroscopy in interventional pain management has led to higher radiation exposure for pain physicians. This study investigated whether or not real-time radiation dose feedback with coaching can reduce the scatter dose received by pain physicians. Firstly, phantom measurements were made to create a scatter dose profile, which visualizes the average scatter radiation for different C-arm positions at 3 levels of height. Secondly, in the clinical part, the radiation dose received by pain physicians during pain treatment procedures was measured real-time to evaluate (1) the effect of real-time dose feedback on the received scatter dose, and (2) the effect of knowledge of the scatter dose profile and active coaching, on the scatter dose received by the pain physician. The clinical study included 330 interventional pain procedures. The results showed that real-time feedback of the received dose did not lead to a reduction in scatter radiation. However, visualization of the scatter dose in a scatter dose profile and active coaching on optimal positions did reduce the scatter radiation received by pain physicians during interventional pain procedures by 46.4% (P = 0.05). Knowledge of and real-time coaching with the scatter dose profile reduced the dose of pain physicians by half, caused by their increased awareness for scatter radiation and their insight into strategic positioning.
authors.affiliation: Department of Medical Physics, Albert Schweitzer Hospital, Dordrecht, the Netherlands.
authors.forename: A S
authors.initials: AS
authors.lastname: Slegers
authors.affiliation: Department of Anesthesiology, Albert Schweitzer Hospital, Dordrecht, the Netherlands.
authors.forename: I
authors.initials: I
authors.lastname: Gültuna
authors.affiliation: Department of Anesthesiology, Albert Schweitzer Hospital, Dordrecht, the Netherlands.
authors.forename: J A
authors.initials: JA
authors.lastname: Aukes
authors.affiliation: Department of Anesthesiology, Albert Schweitzer Hospital, Dordrecht, the Netherlands.
authors.forename: E J J A A
authors.initials: EJ
authors.lastname: van Gorp
authors.affiliation: Department of Radiology, Albert Schweitzer Hospital, Dordrecht, the Netherlands.
authors.forename: F M N
authors.initials: FM
authors.lastname: Blommers
authors.affiliation: Department of Medical Physics, Maasstad Hospital, Rotterdam, the Netherlands.
authors.forename: S P
authors.initials: SP
authors.lastname: Niehof
authors.affiliation: Department of Medical Physics, Albert Schweitzer Hospital, Dordrecht, the Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Bosman
mesh_terms: D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D016273:Occupational Exposure / Q000517:prevention & control*; D059408:Pain Management / Q000379:methods*; D010820:Physicians; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods*; D012542:Scattering, Radiation
keywords: C-arm; coaching; education; fluoroscopy; pain interventions; radiology; scatter dose; scatter dose profile