In plain language
At one US centre, a 20-minute fluoroscopy education session plus a pre-endoscopic retrograde cholangiopancreatography (ERCP) time-out was followed by 28-52% lower patient radiation dose and more use of collimation and low magnification. Staff dose was not measured, though these settings typically reduce scatter.
At a glance
- Type of study
- Original research
- Who was studied
- Gastroenterologists, Trainees, Patients
- Size
- n = 583 procedures
- Where
- United States
- Summary based on
- the full text
What it found
After the 20-minute education and fluoroscopy time-out, total dose fell by about half for low-volume endoscopists and by over a quarter for high-volume endoscopists.
Key figures: LVE 98.3 to 46.9 mGy (52.3%, p=0.0005); HVE 74.1 to 53.1 mGy (28.3%, p<0.0001)
Median fluoroscopy time fell after education in both groups.
Key figures: LVE 5.4 to 3.8 min (30%); HVE 6.4 to 3.3 min (48%); p<0.0001
Dose area product fell after education in both groups.
Key figures: LVE 13.9 to 7.2 Gy-cm2 (48%); HVE 8.8 to 5.7 Gy-cm2 (35.1%); p<0.0001
Preferential use of collimation and low magnification rose substantially after education.
Key figures: Collimation LVE 21.8% to 52.8%, HVE 15% to 71.8%; low magnification LVE 20.5% to 82.9%, HVE 52.2% to 74.1%
Trainee participation did not significantly change radiation parameters in the post-education phase.
Limits to keep in mind
Single-centre pre-post design with nine endoscopists, retrospective baseline data and possible Hawthorne effect in the post phase. Only patient dose metrics were measured, not staff dose.
Related research summaries
- ICRP Draft - Radiological Protection in Fluoroscopically Guided Procedures (Guideline or consensus statement)
- Radiation Exposure, Training, and Safety in Cardiology (2024, Narrative review)
- ICRP Publication 117. Radiological Protection In Fluoroscopically Guided Procedures Performed Outside The Imaging Department (2010, Guideline or consensus statement)
- AST Standards for Ionizing Radiation Exposure (Guideline or consensus statement)
- Cardiology fellows-in-training are exposed to relatively high levels of radiation in the cath lab compared with staff interventional cardiologists, insights from the RECAP trial (2019, Dosimetry measurement study)
How this summary was made
ORSIF prepared this summary with AI assistance from the full text of the paper. A program then checked that the passage supporting each finding appears word for word in that source. A person has not yet reviewed each summary, so read the original before relying on a number. ORSIF summarizes research and does not endorse any product or company. Report a problem with this summary.
Prepared November 3, 2026.