• Ir J Med Sci · Jun 2024

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

    • Delphine Vallot, Ana Cavillon, Amélie Lusque, Philippe Izard, Geneviève Salvignol, Bertrand Delpuech, and Régis Fuzier.
    • Department of Medical Physics, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France.
    • Ir J Med Sci. 2024 Jun 1; 193 (3): 146114661461-1466.

    BackgroundImplantable 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.AimsThis study aimed to evaluate the impact of upgrading the machines and the radiation-protection training on ionizing radiation exposure during venous port system implantation.MethodsWe 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.ResultsWe 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.ConclusionsUpgrading 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.© 2024. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

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