Multicentre survey of radiologically inserted gastrostomy feeding tube (RIG) in the UK

Lowe, Andrew; Laasch, Hans-Ulrich; Stephenson, Sophie; Butterfield, C; Goodwin, Michaela; Kay, Clive; Glancy, Stephen; Jackson, Simon; Brown, David; McLean, Peter; Keanie, Julian; Thrower, Andrew; Briggs, Ruth; Punekar, Samad; Krishnan, Subramaniam; Brigly, Thomas; Yap, Kok Hooi; Mullan, Damian; Maskell, Giles; Hancock, John; Edwards, Andrew J.; Dodds, N; Philips, Alasdair; Heyward, S; Tolan, Damian; Harris, Keith M.; Moss, Edward H.; Hussain, Fuad; Lopez, Anthony; Kennedy, Peter T.; Ellis, Peter; Collins, Anton; Doyle, Timothy E.; Thompson, Phil; Johnston, Malcolm C.; Richenberg, Jonathan; Vallance, Kevin; Dyer, Jules; Higginson, T; Atchley, J.; Corr, Conor; Robinson, Mark; Fleming, David G.; McBride, Katharine; Bhat, Raj; Docherty, Sharron L.; Chowdury, P

doi:10.1016/j.crad.2012.01.014

Cited by 43 publications

(23 citation statements)

References 14 publications

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“…A registry analysis of 17 centers [8] with 106 data sets described a median DAP of 430 cGy*cm 2 . Kloeckner et al [9] report a median DAP of 3260 cGy*cm 2 .…”

Section: Discussionmentioning

confidence: 99%

Analysis of Patients’ X-ray Exposure in 146 Percutaneous Radiologic Gastrostomies

Petersen¹,

Reinhardt²,

Fuchs³

et al. 2017

Fortschr Röntgenstr

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ABSTR AC TPurpose Analysis of patient´s X-ray exposure during percutaneous radiologic gastrostomies (PRG) in a larger population. Materials and MethodsData of primary successful PRGprocedures, performed between 2004 and 2015 in 146 patients, were analyzed regarding the exposition to X-ray. Dose-area-product (DAP), dose-length-product (DLP) respectively, and fluoroscopy time (FT) were correlated with the used x-ray systems (Flatpanel Detector (FD) vs. Image Itensifier (BV)) and the necessity for periprocedural placement of a nasogastric tube. Additionally, the effective X-ray dose for PRG placement using fluoroscopy (DL), computed tomography (CT), and cone beam CT (CBCT) was estimated using a conversion factor. ResultsThe median DFP of PRG-placements under fluoroscopy was 163 cGy*cm 2 (flat panel detector systems: 155 cGy*cm 2 ; X-ray image intensifier: 175 cGy*cm 2 ). The median DLZ was 2.2 min. Intraprocedural placement of a naso-or orogastric probe (n = 68) resulted in a significant prolongation of the median DLZ to 2.5 min versus 2 min in patients with an already existing probe. In addition, dose values were analyzed in smaller samples of patients in which the PRG was placed under CBCT (n = 7, median DFP = 2635 cGy*cm 2 ), or using CT (n = 4, median DLP = 657 mGy*cm). Estimates of the median DFP and DLP showed effective doses of 0.3 mSv for DL-assisted placements (flat panel detector 0.3 mSv, X-ray image converter 0.4 mSv), 7.9 mSv using a CBCT -flat detector, and 9.9 mSv using CT. This corresponds to a factor 26 of DL versus CBCT, or a factor 33 of DL versus CT.Conclusion In order to minimize X-ray exposure during PRGprocedures for patients and staff, fluoroscopically-guided interventions should employ flat detector systems with short transmittance sequences in low dose mode and with slow image frequency. Series recordings can be dispensed with. The intraprocedural placement of a naso-or orogastric probe significantly extends FT, but has little effect on the overall dose of the intervention. Due to the significantly higher X-ray exposure, the use of a CBCT as well as PRG-placements using CT should be limited to clinically absolutely necessary exceptions with strict indication. Ergebnisse Das mediane DFP von PRG-Anlagen unter DL lag bei 163 cGy*cm 2 (FD: 155 cGy*cm 2 ; BV: 175 cGy*cm 2 ). Die mediane DLZ betrug 2,2 min. Dabei führte eine intraprozedurale Anlage einer naso-oder orogastralen Sonde (n = 68) zu einer signifikanten Verlängerung der medianen DLZ auf 2,5 min gegenüber 2 min bei Patienten mit bereits liegender Sonde. Zusätzlich wurden Dosiswerte von kleineren Patientengruppen analysiert, bei denen die PRG CBCT-gestützt (n = 7; medianes DFP = 2635 cGy*cm 2 ), oder CT-gestützt (n = 4, medianes DLP = 657 mGy*cm) angelegt wurde. Durch Abschätzungen aus den medianen DFP bzw. DLP ergaben sich effektive Dosen von 0,3 mSv für DL-gestützte Anlagen (FD 0,3 mSv; BV 0,4 mSv), mittels FD mit CBCT 7,9 mSv, und bei PRG-Anlagen im CT eine effektive Dosis von 9,9 mSv. Das entspricht einem Faktor 26 von DL gegenüber ...

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“…A registry analysis of 17 centers [8] with 106 data sets described a median DAP of 430 cGy*cm 2 . Kloeckner et al [9] report a median DAP of 3260 cGy*cm 2 .…”

Section: Discussionmentioning

confidence: 99%

Analysis of Patients’ X-ray Exposure in 146 Percutaneous Radiologic Gastrostomies

Petersen¹,

Reinhardt²,

Fuchs³

et al. 2017

Fortschr Röntgenstr

View full text Add to dashboard Cite

show abstract

“…1 The authors report a 2% incidence of tubes "falling out" in <30 days and "some" patients requiring multiple tube reinsertions in <30 days. 1 The likelihood is that the loop-retained tubes were the main offenders.…”

mentioning

confidence: 96%

“…1 The audit covers a large aspect of the practice and is undoubtedly an addition to the knowledge pertaining to RIG placements. However, we would like to raise some important aspects that we feel would have enhanced the survey.…”

mentioning

confidence: 99%

Re: Multicentre survey of radiologically inserted gastrostomy feeding tube (RIG) in the UK

et al. 2013

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“…The database for antibiotic prophylaxis in PEG is comprehensive [475]. There is data for RIG showing no wound infections [466]. In general, the introducer technique has a lower infection rate [465].…”

Section: Recommendation 57mentioning

confidence: 99%

“…A multicenter survey of RIG with 684 patients in 17 centers found a mortality of 1 % and a complication rate of 5 % [466]. With PEG, a prospective study (n = 484) reported a high incidence of complications at 2 and 8 weeks of 39 % and 27 %, respectively [467].…”

Section: Introductionmentioning

confidence: 99%

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Ultraschall in Med

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Multicentre survey of radiologically inserted gastrostomy feeding tube (RIG) in the UK

Cited by 43 publications

References 14 publications

Analysis of Patients’ X-ray Exposure in 146 Percutaneous Radiologic Gastrostomies

Analysis of Patients’ X-ray Exposure in 146 Percutaneous Radiologic Gastrostomies

Re: Multicentre survey of radiologically inserted gastrostomy feeding tube (RIG) in the UK

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