Comparative ergonomic workflow and user experience analysis of MRI versus fluoroscopy-guided vascular interventions: an iliac angioplasty exemplar case study

Fabiola Fernández-Gutiérrez (Lead / Corresponding author), Santiago Martínez, Martin A. Rube, Benjamin F. Cox, Mahsa Fatahi, Kenneth C. Scott-Brown, J. Graeme Houston, Helen McLeod, Richard D. White, Karen French, Mariana Gueorguieva, Erwin Immel, Andreas Melzer

    Research output: Contribution to journalArticlepeer-review

    8 Citations (Scopus)


    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.

    Original languageEnglish
    Pages (from-to)1639-1650
    Number of pages12
    JournalInternational Journal of Computer Assisted Radiology and Surgery
    Issue number10
    Early online date21 Feb 2015
    Publication statusPublished - Oct 2015


    • Ergonomic analysis
    • Interventional MRI workflow
    • MR-guided angioplasty
    • Retrospective protocol analysis

    ASJC Scopus subject areas

    • Radiology Nuclear Medicine and imaging
    • Health Informatics
    • Surgery


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