Effect of the learning process on procedure times and radiation exposure for CT fluoroscopy-guided percutaneous biopsy procedures

PURPOSE: To assess if the learning process associated with computed tomogra phy fluoroscopy (CTF) technology influences procedure and fluoroscopy times for percutaneous biopsy procedures. MATERIALS AND METHODS: Prospective analysis of the initial 250 consecutive patients who underwent percutaneous biopsy with use of a CT scanner equippe d with rapid image reconstruction and fluoroscopic capabilities in a 24-mon th period, All procedures were performed with both continuous and spot fluo roscopic technique, with typical radiation parameters of 50 mA, 120 kV, and a 10-mm-slice thickness. The procedures were all performed by a single exp erienced interventional radiologist to limit the variables of physician exp ertise, interventional materials used, and biopsy approach, The subject gro up was divided into five equal consecutive groups of 50 patients. In each s ubgroup, the authors recorded mean lesion size, success, and complication r ates, as well as mean procedure and fluoroscopy times, RESULTS: The five subgroups were similar patient populations as documented by the absence of statistically significant differences when comparing mean lesion size, procedure success, and complication rates (P >.05; ANOVA test ). A statistically significant decrease in mean fluoroscopy (groups 1-5: 50 .26 vs 45.24 vs 33.86 vs 32.68 vs 25.8 sec/patient) and mean procedure time s (groups 1-5: 30.08 vs 27.9 vs 26.34 vs 25.6 vs 21.6 min/patient) was reco rded between the patient subgroups (P <.0001; ANOVA test). CONCLUSION: The learning process associated with CTF technology impacts pro cedure parameters by decreasing both mean procedure and fluoroscopy times, thereby increasing patient turnover and decreasing radiation exposure to th e patient and the operator.