Contrast Media Use in Radiation Oncology: A Prospective, Controlled Educational Intervention Study With Retrospective Analysis of Patient Outcomes

Abstract

Purpose Intravenous contrast media (ICM) administration is recommended as part of radiation therapy (RT) simulation in a variety of clinical scenarios, but can cause adverse events. We sought to assess radiation oncology resident knowledge about ICM, and to determine if an educational intervention (EI) could improve this level of knowledge. In conjunction, we retrospectively analyzed risk factors and adverse events related to ICM use before and after the EI to determine whether any improvements in patient outcomes could be realized. Methods Over 2 years, 21 residents in radiation oncology at Memorial Sloan-Kettering Cancer Center (MSKCC) participated in a pretest-EI-posttest study based on the ACR’s Manual on Contrast Media. Medical and RT records were reviewed, and ICM use, risk factors and adverse events were recorded. Results There was no significant difference in resident understanding of ICM use in residents of different years of training (p=0.85). Understanding of ICM use increased in residents that attended the EI (p<0.05), but this was not sustained 1 year after the EI (p=0.48). Of the 6852 RT simulations that were performed at MSKCC, 1350 (19.7%) involved ICM. Mild adverse events occurred in a few patients (<5%) simulated with ICM, but there was no difference in the number of risk factors or adverse events before and after the EI. Conclusions The EI effectively improved short-term understanding of ICM use. However, the effect was not sustained. The frequency of adverse events related to ICM use was small and not significantly impacted by the EI.

Simulated consult and treatment exercise improves radiation oncology trainee confidence and knowledge

“…The use of structured educational interventions in radiation oncology was previously studied by Barker et al ., who examined whether resident knowledge regarding contrast administration could be improved and whether the improvement was sustained one year later. [ 10 ] While their intervention improved knowledge among those residents who attended, improvement was not sustained at the one-year mark. While this highlights the limitations of a single-session educational intervention, this is less of a concern for educational interventions pertaining to introductory topics repeated annually during new resident orientation.…”