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

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Abstract

Background

Implantable 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.

Aims

This study aimed to evaluate the impact of upgrading the machines and the radiation-protection training on ionizing radiation exposure during venous port system implantation.

Methods

We 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.

Results

We 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.

Conclusions

Upgrading 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.

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Acknowledgements

The authors wish to thank Morgane Marcou (Research Coordinator, IUCT-Oncopole, Toulouse) for hel** to obtain the different authorizations to carry out this study, Cathy Roca (Continuous Education Unit, IUCT-Oncopole, Toulouse) for organizing the training courses, and Sébastien Balduyck from University Hospital Center of Toulouse for the second training course. The authors also thank Pétra Neufing, an independent scientific language editing service, for the English revision of the present manuscript.

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Authors and Affiliations

  1. Department of Medical Physics, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France

    Delphine Vallot

  2. Department of Biostatistics and Health Data Science, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France

    Ana Cavillon & Amélie Lusque

  3. Department of Anesthesiology, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France

    Philippe Izard, Geneviève Salvignol & Régis Fuzier

  4. Department of Radioprotection, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France

    Bertrand Delpuech

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  1. Delphine Vallot
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Correspondence to Régis Fuzier.

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Vallot, D., Cavillon, A., Lusque, A. et al. Radiation dose reduction during venous access port implantation: the importance of upgrading equipment and radiation-protection training. Ir J Med Sci 193, 1461–1466 (2024). https://doi.org/10.1007/s11845-024-03623-7

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  • DOI: https://doi.org/10.1007/s11845-024-03623-7

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