Reducing radiation exposure in neurointervention through dedicated training on the biplane angiographic system

To investigate whether the radiation dose in neurointerventional procedures is reduced if the interventionalist has a better working knowledge and skill to operate the biplane angiographic system (BAS).

It is common practice in most centres in the UK for radiographers to drive many of the functions of the BAS under the instruction of the interventionalist who performs the procedure. The dose profile of a neurointerventionalist who was trained to perform procedures while operating the BAS independently was evaluated against that of a highly experienced neurointerventionalist when operating with a radiographer-assisted BAS.

The dose-area product for 57 procedures was collected retrospectively. Working independently resulted in a statistically significant lower mean dose of 4,655 μGy·m² compared to mean doses above 7,000 μGy·m² with a radiographer-assisted BAS (p<0.05). Effectively this allowed for the mean dose to be reduced by as much as 38%.

This study suggests that improved knowledge and skill in operating the BAS gives the neurointerventionalist the opportunity to minimise radiation dose. Therefore, this should be part of the skillset acquired by a qualified neurointerventionalist and be formally addressed in the interventional radiology curriculum.¹⁸.