By combining AI-assisted fluoroscopy with additional lead shielding, the system was found to significantly lower radiation scatter reaching endoscopy and anesthesia personnel, potentially improving occupational safety. However, further research is needed to validate these findings across different clinical settings and evaluate their long-term benefits.
Fluoroscopy-guided endoscopic procedures are widely used for the diagnosis and treatment of gastrointestinal disorders. Although these procedures are invaluable in clinical practice, they expose healthcare workers to ionizing radiation, which can accumulate over time and increase the risk of radiation-related health complications. While protective equipment is routinely used, strategies to further minimize radiation scatter remain an important area of investigation.
Against this backdrop, researchers led by Ji Young Bang from the Digestive Health Institute, Orlando Health, Orlando, Florida, USA, evaluated whether a newly developed lead flap-enhanced artificial intelligence-enabled fluoroscopy (LE-AIF) system could provide greater protection against radiation scatter compared with a conventional AI-enabled fluoroscopy (C-AIF) system.
The prospective study included 218 patients who underwent fluoroscopy-guided endoscopic procedures. Participants were managed using either the conventional AI-enabled fluoroscopy system or the newly designed LE-AIF system. The primary objective was to compare the amount of radiation scatter reaching endoscopists during procedures. Radiation exposure to anesthesia personnel was also assessed to determine whether the enhanced shielding offered broader protection to operating room staff.
Key Findings:
- The lead flap-enhanced, AI-enabled fluoroscopy (LE-AIF) system significantly reduced radiation scatter exposure for both endoscopists and anesthesia personnel compared with the conventional fluoroscopy setup.
- Incorporating an additional lead flap into the fluoroscopy system substantially improved radiation protection without altering the procedural workflow.
- Use of the conventional AI-enabled fluoroscopy system was independently associated with higher radiation scatter exposure.
- Longer fluoroscopy duration was also independently linked to increased radiation scatter exposure.
The findings underscore the importance of adopting enhanced shielding technologies and minimizing fluoroscopy time, whenever clinically feasible, to reduce radiation exposure.
The researchers noted that reducing occupational radiation exposure remains a priority, particularly for healthcare professionals who routinely perform fluoroscopy-guided procedures. The enhanced fluoroscopy system may offer a practical way to improve workplace safety by lowering cumulative radiation exposure.
The study concluded that the lead flap-enhanced, artificial intelligence-enabled fluoroscopy system significantly reduced radiation scatter during fluoroscopy-guided endoscopic procedures. The authors suggested that this approach could serve as an effective radiation protection strategy for endoscopy teams, while emphasizing the need for further studies to validate its effectiveness and assess its applicability across diverse clinical settings.
Reference:
Bang, Ji Young MD MPH1; Hawes, Robert MD1; Varadarajulu, Shyam MD1,a. Radiation scatter at fluoroscopy-guided endoscopic procedures: Building towards further optimization. The American Journal of Gastroenterology ():10.14309/ajg.0000000000004097, June 26, 2026. | DOI: 10.14309/ajg.0000000000004097
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