Fellowship training benefits uterine artery embolization privileging, credentialing

Fellowship training should be the basis for uterine artery embolization (UAE) privileging and credentialing, according to a study published online Feb. 12 by the Journal of the American College of Radiology.

An accepted alternative to medical and surgical treatment for uterine fibroids, UAE can be diagnostically and technically challenging. Fluoroscopy time and contrast media volume are safety metrics identified to illustrate the operator’s skill level. Senior author David M. Liu, MD, of Vancouver General Hospital, and colleagues strove to determine if it was feasible to measure a training effect in the two metrics within a standardized UAE procedure during a one year interventional radiology fellowship program.

The researchers performed a retrospective single-center study in 323 consecutive women treated with UAE for symptomatic uterine fibroids. Twelve clinical interventional radiology trainees under the supervision of seven staff radiologists were the focal part of the study.

Each trainee saw an average of 27 patients during the study. The mean total fluoroscopic time was 24.6 minutes per study for all fellows. The mean contrast volume was 190 mL.

While increasing the uterine volume had no significant effect on fluoroscopic time, contrast media volume significantly increased. A significant training effect was evident with decrease in fluoroscopic time and decrease in contrast volume over training. During the fellowship’s course, these metrics contributed to a 12-minute decrease in UAE fluoroscopy time and 17 mL less contrast.

“We have documented that, through supervised training, patient safety can be improved by decreasing fluoroscopic time and decreased contrast media usage,” wrote Liu and colleagues.