Use of Artificial Intelligence to Reduce Radiation Exposure at Fluoroscopy-Guided Endoscopic Procedures
Ji Young Bang, MD October 30, 2019
Introduction: Exposure to ionizing radiation remains a hazard for patients and healthcare providers. We evaluated the utility of an artificial intelligence (AI) enabled fluoroscopy system to minimize radiation exposure during image-guided endoscopic procedures.
Methods: We conducted a prospective study of 100 consecutive patients who underwent fluoroscopy-guided endoscopic procedures. Patients underwent interventions utilizing either conventional or AI-equipped fluoroscopy system that utilizes ultra-fast collimation to limit radiation exposure to the region of interest. Main outcome measure was to compare radiation exposure to patients which was measured by dose area product (DAP). Secondary outcome was radiation scatter to endoscopy personnel measured using dosimeter.
Results: Of 100 patients who underwent procedures using traditional (n=50) or AI-enabled (n=50) fluoroscopy systems, there was no significant difference in demographics, body mass index, procedural type, procedural or fluoroscopy time between the conventional and the AI-enabled fluoroscopy systems. Radiation exposure to patients was lower (median DAP 2178 vs. 5708mGym2, p=0.001) and scatter effect to endoscopy personnel was less (total deep dose equivalent 0.28 vs. 0.69mSv; difference of 59.4%) for AI-enabled fluoroscopy as compared to conventional system. On multivariate linear regression analysis, after adjusting for patient characteristics, procedural/fluoroscopy duration and type of fluoroscopy system, only AI-equipped fluoroscopy system (coefficient 3331.9 [95% CI 1926.8-4737.1, p <0.001) and fluoroscopy duration (coefficient 813.2 [95% CI 640.5-985.9], p<0.001) were associated with radiation exposure.
Discussions: The AI-enabled fluoroscopy system significantly reduces radiation exposure to patients and scatter effect to endoscopy personnel. ClinicalTrial.gov: NCT03985488
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Link to abstract: http://bit.ly/2MGFyDy