Quantification of Avoidable Radiation Exposure in Interventional Fluoroscopy With Eye Tracking Technology

OBJECTIVES: Reducing avoidable radiation exposure during medical procedures is a top priority. The purpose of this study was to quantify, for the first time, the percentage of avoidable radiation during fluoroscopically guided cardiovascular interventions using eye tracking technologies. MATERIALS AND METHODS: Mobile eye tracking glasses were used to measure precisely when the operators looked at a fluoroscopy screen during the interventions. A novel machine learning algorithm and image processing techniques were used to automatically analyze the data and compute the percentage of avoidable radiation. Based on this percentage, the amount of potentially avoidable radiation dose was computed. RESULTS: This study included 30 cardiovascular interventions performed by 5 different operators. A significant percentage of the administered radiation (mean [SD], 43.5% [12.6%]) was avoidable (t29 = 18.86, P < 0.00001); that is, the operators were not looking at the fluoroscopy screen while the x-ray was on. On average, this corresponded to avoidable amounts of air kerma (mean [SD], 229 [66] mGy) and dose area product (mean [SD], 32,781 [9420] mGycm), or more than 11 minutes of avoidable x-ray usage, per procedure. CONCLUSIONS: A significant amount of the administered radiation during cardiovascular interventions is in fact avoidable.