Fabiola Fernández-Gutiérrez1, Santiago Martínez2,3, Martin A Rube4, Benjamin F Cox4, Mahsa Fatahi4, Kenneth C Scott-Brown2, J Graeme Houston5,6, Helen McLeod6, Richard D White5,7, Karen French4, Mariana Gueorguieva4, Erwin Immel4, Andreas Melzer4. 1. Division of Imaging and Technology, Institute for Medical Science and Technology, University of Dundee, Wilson House, 1 Wurzburg Loan, Dundee, DD2 21FD, UK. fabiola.fg@gmail.com. 2. Centre for Psychology, Abertay University, Dundee, UK. 3. eHealth and Healthcare Centre, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway. 4. Division of Imaging and Technology, Institute for Medical Science and Technology, University of Dundee, Wilson House, 1 Wurzburg Loan, Dundee, DD2 21FD, UK. 5. Department of Clinical Radiology, Ninewells Hospital and Medical School, NHS Tayside, Dundee, UK. 6. Medical Research Institute, The Institute of Cardiovascular Research, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK. 7. Department of Clinical Radiology, University Hospital of Wales, Cardiff, UK.
Abstract
PURPOSE: A methodological framework is introduced to assess and compare a conventional fluoroscopy protocol for peripheral angioplasty with a new magnetic resonant imaging (MRI)-guided protocol. Different scenarios were considered during interventions on a perfused arterial phantom with regard to time-based and cognitive task analysis, user experience and ergonomics. METHODS: Three clinicians with different expertise performed a total of 43 simulated common iliac angioplasties (9 fluoroscopic, 34 MRI-guided) in two blocks of sessions. Six different configurations for MRI guidance were tested in the first block. Four of them were evaluated in the second block and compared to the fluoroscopy protocol. Relevant stages' durations were collected, and interventions were audio-visually recorded from different perspectives. A cued retrospective protocol analysis (CRPA) was undertaken, including personal interviews. In addition, ergonomic constraints in the MRI suite were evaluated. RESULTS: Significant differences were found when comparing the performance between MRI configurations versus fluoroscopy. Two configurations [with times of 8.56 (0.64) and 9.48 (1.13) min] led to reduce procedure time for MRI guidance, comparable to fluoroscopy [8.49 (0.75) min]. The CRPA pointed out the main influential factors for clinical procedure performance. The ergonomic analysis quantified musculoskeletal risks for interventional radiologists when utilising MRI. Several alternatives were suggested to prevent potential low-back injuries. CONCLUSIONS: This work presents a step towards the implementation of efficient operational protocols for MRI-guided procedures based on an integral and multidisciplinary framework, applicable to the assessment of current vascular protocols. The use of first-user perspective raises the possibility of establishing new forms of clinical training and education.
PURPOSE: A methodological framework is introduced to assess and compare a conventional fluoroscopy protocol for peripheral angioplasty with a new magnetic resonant imaging (MRI)-guided protocol. Different scenarios were considered during interventions on a perfused arterial phantom with regard to time-based and cognitive task analysis, user experience and ergonomics. METHODS: Three clinicians with different expertise performed a total of 43 simulated common iliac angioplasties (9 fluoroscopic, 34 MRI-guided) in two blocks of sessions. Six different configurations for MRI guidance were tested in the first block. Four of them were evaluated in the second block and compared to the fluoroscopy protocol. Relevant stages' durations were collected, and interventions were audio-visually recorded from different perspectives. A cued retrospective protocol analysis (CRPA) was undertaken, including personal interviews. In addition, ergonomic constraints in the MRI suite were evaluated. RESULTS: Significant differences were found when comparing the performance between MRI configurations versus fluoroscopy. Two configurations [with times of 8.56 (0.64) and 9.48 (1.13) min] led to reduce procedure time for MRI guidance, comparable to fluoroscopy [8.49 (0.75) min]. The CRPA pointed out the main influential factors for clinical procedure performance. The ergonomic analysis quantified musculoskeletal risks for interventional radiologists when utilising MRI. Several alternatives were suggested to prevent potential low-back injuries. CONCLUSIONS: This work presents a step towards the implementation of efficient operational protocols for MRI-guided procedures based on an integral and multidisciplinary framework, applicable to the assessment of current vascular protocols. The use of first-user perspective raises the possibility of establishing new forms of clinical training and education.
Authors: F J Pérez-Duarte; M Lucas-Hernández; A Matos-Azevedo; J A Sánchez-Margallo; I Díaz-Güemes; F M Sánchez-Margallo Journal: Surg Endosc Date: 2013-12-13 Impact factor: 4.584
Authors: Kelvin H Kramp; Marc J van Det; Eric R Totte; Christiaan Hoff; Jean-Pierre E N Pierie Journal: Surg Endosc Date: 2014-01-01 Impact factor: 4.584
Authors: Isabelle Van Herzeele; Rajesh Aggarwal; Simon Neequaye; Ara Darzi; Frank Vermassen; Nicholas J Cheshire Journal: J Vasc Surg Date: 2008-09-04 Impact factor: 4.268
Authors: Hao Su; Ka-Wai Kwok; Kevin Cleary; Iulian Iordachita; M Cenk Cavusoglu; Jaydev P Desai; Gregory S Fischer Journal: Proc IEEE Inst Electr Electron Eng Date: 2022-05-03 Impact factor: 14.910