Reducing Radiation Dose in Pediatric Diagnostic Fluoroscopy.
OBJECTIVE
To assess radiation dose in common pediatric diagnostic fluoroscopy procedures and determine the efficacy of dose tracking and dose reduction training to reduce radiation use.


METHODS
Fluoroscopy time and radiation dose area product (DAP) were recorded for upper GIs (UGI), voiding cystourethrograms (VCUGs), and barium enemas (BEs) during a six-month period. The results were presented to radiologists followed by a 1-hour training session on radiation dose reduction methods. Data were recorded for an additional six months. DAP was normalized to fluoroscopy time, and Wilcoxon testing was used to assess for differences between groups.


RESULTS
Data from 1,479 cases (945 pretraining and 530 post-training) from 9 radiologists were collected. No statistically significant difference was found in patient age, proportion of examination types, or fluoroscopy time between the pre- and post-training groups (P ≥ .1), with the exception of a small decrease in median fluoroscopy time for VCUGs (1.0 vs 0.9 minutes, P = .04). For all examination types, a statistically significant decrease was found in the median normalized DAP (P < .05) between pre- and post-training groups. The median (quartiles) for pretraining and post-training normalized DAPs (μGy·m(2) per minute) were 14.36 (5.00, 38.95) and 6.67 (2.67, 17.09) for UGIs; 13.00 (5.34, 32.71) and 7.16 (2.73, 19.85) for VCUGs; and 33.14 (9.80, 85.26) and 17.55 (7.96, 46.31) for BEs.


CONCLUSIONS
Radiation dose tracking with feedback, paired with dose reduction training, can reduce radiation dose during diagnostic pediatric fluoroscopic procedures by nearly 50%.
Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. Electronic address: ghodadraag@upmc.edu.
Anish
A
Ghodadra
Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Stefano
S
Bartoletti
D005471:Fluoroscopy; D006801:Humans; D007318:Inservice Training; D010372:Pediatrics / Q000193:education*; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods*; D011871:Radiology / Q000193:education*; D013997:Time Factors
Pediatric fluoroscopy; dose reduction; radiation dose; training