S0950 A Comparison of Radiation Exposure During ERCP by Different Fluoroscope Techniques
Bibliographic record
Abstract
INTRODUCTION: Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic procedure performed for multiple diagnostic and therapeutic indications. It carries benefits and risks like all other interventions. We focused on radiation exposure to patients and staff. In the literature review, we found that radiation dose is lower when radiation administration is physician-controlled, and as the physician becomes more experienced, they utilize less radiation. The aim was to compare different operation techniques of radiation administration during ERCP. METHODS: This was a retrospective study of all 437 ERCP procedures performed at a tertiary care hospital between April 2015 and April 2017. Data were collected from the hospital electronic system and included demographics, procedure indication, fluoroscopy time (FT), dose area product (DAP), degree of difficulty as per American Society of Gastrointestinal Endoscopy (ASGE) recommendations. Median and mean FT and DAP between endoscopist- controlled (EC) compared to technician-controlled (TC). RESULTS: Of the 437 cases analyzed 45.5%males, and the mean age was 56.7. EC was 187 cases, representing 42.79%. The mean fluoroscopy time (FT) was 2.107 ± 2.0 minutes. The mean dose–area product (DAP) was 15227.371 ± 16784.738 Gy·cm2 for all procedures. The degree of ERCP difficulty was graded from 1-4 as per ASGE. Level I TC procedures had a mean FT and DAP of 1.600 minutes and 12644.72 Gy·cm2, respectively; level I EC procedures were1.514 minutes and 12966.71 Gy·cm2, respectively. For level IV, TC procedures the mean FT, 2.539 minutes, and the mean DAP was 19469.94 Gy·cm2. For level IV EC procedures, the mean FT was 4.890 minutes; the mean DAP was 37921.00 Gy·cm2. CONCLUSION: This study did not show a significant difference in radiation dose between EC and TC except in ASGE level IV, where a significant increase noticed in the EC group. The results of multiple other fluoroscopic studies in urology and cardiology showed that when the procedure is physician-controlled, radiation administered is similar or lower than TC. This difference in comparison to the other studies could be attributed to the endoscopist attention divided into multiple fronts, including doing the procedure that predisposes them to push on the pedal for longer than intended while manipulating the scope and leading the team. Although these results are inconclusive, it does shed light on the importance of further studies on radiation administration techniques for patients and staff safety.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".