Changing Patterns in the Performance of Fluoroscopically Guided Interventional Procedures and Adherence to Radiation Safety Practices in a U.S. Cohort of Radiologic Technologists

Abstract

Objective: Information is limited on changes over time in the types of fluoroscopically guided interventional procedures performed and associated radiation safety practices used by radiologic technologists.

Materials and methods: Our study included 12,571 U.S. radiologic technologists who were certified for at least 2 years in 1926-1982 and who reported in a 2012-2013 survey that they ever performed or assisted with fluoroscopically guided interventional procedures. They completed a mailed questionnaire in 2013-2014 describing their detailed work practices for 21 fluoroscopically guided interventional procedures and associated radiation safety practices from the 1950s through 2009.

Results: Overall, the proportion of technologists who reported working with therapeutic fluoroscopically guided interventional procedures, including percutaneous coronary interventions, increased over time, whereas the proportion of technologists who worked with diagnostic fluoroscopically guided interventional procedures, including diagnostic cardiovascular catheterization and neuroangiographic procedures, decreased. We also observed substantial increases in the median number of times per month that technologists worked with diagnostic cardiovascular catheterizations and percutaneous coronary interventions. In each time period, most technologists reported consistently (≥ 75% of work time) wearing radiation monitoring badges and lead aprons during fluoroscopically guided interventional procedures. However, fewer than 50% of the technologists reported consistent use of thyroid shields, lead glasses, and room shields during fluoroscopically guided interventional procedures, even in more recent time periods.

Conclusion: This study provides a detailed historical assessment of fluoroscopically guided interventional procedures performed and radiation safety practices used by radiologic technologists from the 1950s through 2009. Results can be used in conjunction with badge dose data to estimate organ radiation dose for studies of radiation-related health risks in radiologic technologists who have worked with fluoroscopically guided interventional procedures.

Keywords: cardiovascular catheterizations; fluoroscopically guided procedures; radiation safety practices; radiologic technologists.

Fig. 1-

Proportion of radiologic technologists who performed or assisted with therapeutic or diagnostic fluoroscopically guided interventional (FGI) procedures from before 1970 to 2009, U.S. Radiologic Technologists Study. Supplementary Table 1 shows types of specific diagnostic and therapeutic FGI procedures.

Fig. 2-

Proportion of radiologic technologists who performed or assisted with fluoroscopically guided interventional (FGI) procedures from before 1970 to 2009, U.S. Radiologic Technologists Study.

Fig. 3-

Median frequency of fluoroscopically guided interventional (FGI) procedures performed or assisted per month, among radiologic technologists who reported ever performing or assisting with the specific FGI procedure, before 1970 to 2009, US Radiologic Technologists Study. (ERCP: Endoscopic retrograde cholangiopancreatography, PCNL: Percutaneous nephrolithotomy, TIP: Transjugular intrahepatic portosystemic shunts)

Fig. 4-

Proportion of radiologic technologists who consistently (75 – 100% of the time) used protective measurements during fluoroscopically guided interventional (FGI) procedures from before 1970 to 2009, US Radiologic Technologists Study.