Contrast media use in radiation oncology: a prospective, controlled educational intervention study with retrospective analysis of patient outcomes.

摘要

PURPOSE: Intravenous contrast media (ICM) administration is recommended as part of radiation therapy simulation in a variety of clinical scenarios but can cause adverse events. The aims of this study were to assess radiation oncology residents' knowledge about ICM and to determine if an educational intervention (EI) could improve this level of knowledge. In conjunction, risk factors and adverse events related to ICM use were retrospectively analyzed 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 participated in a pretest-EI-posttest study based on the ACR's Manual on Contrast Media. Medical and radiation therapy records were reviewed, and ICM use, risk factors, and adverse events were recorded. RESULTS: There was no significant difference in residents' understanding of ICM use in residents of different years of training (P = .85). Understanding of ICM use increased in residents who attended the EI (P < .05), but this was not sustained 1 year after the EI (P = .48). Of the 6,852 radiation therapy simulations that were performed at Memorial Sloan-Kettering, 1,350 (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 affected by the EI.