title: Improving Patient Safety: Implementing Dose Monitoring Software in Fluoroscopically Guided Interventions.
abstract: OBJECTIVE
  To assess whether dose monitoring software can be successfully implemented in fluoroscopically guided interventions and to provide dose data based on levels of complexity.
  
  
  METHODS
  After launching the software (DoseWatch; GE Healthcare Systems, Buc, France), data were collected for 6 months and analyzed by means of kerma-area product (KAP; Gy/cm(2)), cumulative air kerma (KA,R; Gy), and fluoroscopic time (minutes). Data analysis was executed by level of complexity as graded by the operators. Complexity grading was based on factors such as tortuosity and calcification of vessel, variant anatomy, and patient cooperation.
  
  
  RESULTS
  The software successfully transferred dose data of 357 fluoroscopically guided procedures. KAP was 0.238-400 Gy/cm(2) with mean, median, and 75th percentile values of 46.0 Gy/cm(2), 163.2 Gy/cm(2), and 541.1 Gy/cm(2) (KA,R, 0.013-4.1 Gy; mean, median, 75th percentile, 0.48 Gy, 0.97 Gy, 3.98 Gy). Highest dose values were seen in transarterial chemoembolization (KAP mean, median, 75th percentile, 229.5 Gy/cm(2), 216.4 Gy/cm(2), 299.9 Gy/cm(2); KA,R mean, median, 75th percentile, 1.9 Gy, 1.2 Gy, 1.7 Gy). Analysis revealed that the level of complexity strongly correlated with KAP (r = 0.88; P < .001) whereas there was no direct correlation of KAP and fluoroscopy time. During the same intervention, KA,R and fluoroscopy time increased with level of complexity, but the correlation was not statistically significant.
  
  
  CONCLUSIONS
  Implementation of dose monitoring software in fluoroscopically guided interventions can be successfully accomplished, and it facilitates data comparison.
authors.affiliation: Department of Radiology and Nuclear Medicine, Stadtspital Triemli Zurich, Birmensdorferstreet 497, Zurich CH-8063, Switzerland. Electronic address: christina.heilmaier@triemli.zurich.ch.
authors.forename: Christina
authors.initials: C
authors.lastname: Heilmaier
authors.affiliation: Department of Radiology and Nuclear Medicine, Stadtspital Triemli Zurich, Birmensdorferstreet 497, Zurich CH-8063, Switzerland.
authors.forename: Zuber
authors.initials: Z
authors.lastname: Niklaus
authors.affiliation: Department of Radiology and Nuclear Medicine, Stadtspital Triemli Zurich, Birmensdorferstreet 497, Zurich CH-8063, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Berthold
authors.affiliation: Department of Radiology and Nuclear Medicine, Stadtspital Triemli Zurich, Birmensdorferstreet 497, Zurich CH-8063, Switzerland.
authors.forename: Levent
authors.initials: L
authors.lastname: Kara
authors.affiliation: Department of Radiology and Nuclear Medicine, Stadtspital Triemli Zurich, Birmensdorferstreet 497, Zurich CH-8063, Switzerland.
authors.forename: Dominik
authors.initials: D
authors.lastname: Weishaupt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005471:Fluoroscopy / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods / Q000706:statistics & numerical data*; D061214:Patient Safety / Q000706:statistics & numerical data*; D011829:Radiation Dosage; D011834:Radiation Monitoring / Q000379:methods / Q000706:statistics & numerical data*; D011835:Radiation Protection; D015641:Radiography, Interventional / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012984:Software; D012986:Software Validation; D025321:Surgery, Computer-Assisted / Q000706:statistics & numerical data; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult