A Study to Compare the Radiation Absorbed Dose of the C-arm Fluoroscopic Modes

Cho, Jaehun; Kim, Jae Yun; Kang, Joo Eun; Park, Pyong Eun; Lim, Jeong Ae; Kim, Hae Kyoung; Woo, Nam Sik

doi:10.3344/kjp.2011.24.4.199

Cited by 34 publications

(31 citation statements)

References 13 publications

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“…Aprons, lead glasses, thyroid protectors, and lead gloves must be used properly to minimize radiation exposure to medical personnel. The use of pulsed fluoroscopy mode also reduces radiation exposure 13,14) . Unless a precise image is required, the pulsed mode is recommended for mobile C-arm fluoroscopy.…”

Section: Discussionmentioning

confidence: 99%

Comparisons of the Amount of Radiation Exposure Among Medical Personnels in Percutaneous Vertebroplasty

Yu¹,

Lee²,

Shin³

et al. 2017

Asian J Pain

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Objective: X-ray has been used for visualizing internal lesions despite of its biological hazard. Fluoroscopic technique is essential in the modern spinal interventions due to its simplicity and sharpness. Radiation hazard is often under estimated due to Intangible property and late effect. The purpose of this study was to assess radiation exposure during percutaneous vertebroplasty (PVP) which is one of the most frequently performed spinal interventions. Methods: We performed a prospective analysis of a total of 17 consecutive cases of PVP between January 2012 to august 2012. Sixteen patients were osteoporotic compression fractures. One case underwent PVP for pathological compression fracture. Exposure time was calculated automatically by a fluoroscope. For medical personnel, we put a thermoluminescent dosimeters (TLD) on the midpoint of the sternum inside a body apron and another one on the midpoint of a thyroid protector. For patients, one TLD was placed on the table anterior to patient's neck and another one on the table anterior to the treatment level. All TLDs were sent to the lab immediately after PVP. The cumulative dose recorded for each TLD badge was analyzed. Results: The exposure time per one vertebra was 323.77±23.96 seconds, ranging 207.00 to 547.00 seconds. The exposure dose measured on a thyroid protector was 2.97±0.54 mSv, ranging 2.11 to 3.21 mSv in the surgeon, 0.04±0.11 mSv, ranging 0.02 to 0.14 mSv in the assistant surgeon, and 0.11±0.02 mSv, ranging 0.08 to 0.15 mSv in the nurse. The exposure dose measured in the radio-protective apron was 0.20±0.04 mSv, ranging 0.15 to 0.30 mSv in the surgeon, 0.01±0.005, ranging 0.005 to 0.03 mSv in the assistant surgeon, and 0.04±0.01 mSv, ranging 0.02 to 0.10 mSv in the nurse. The patient showed 0.44±0.14 mSv, ranging 0.33 to 0.54 mSv in the neck area and 3.97. 0.52 mSv, ranging 3.44 to 4.12 mSv in the treated area. Conclusion: The amount of radiation exposure was different among medical personnel in performing PVP. The major contributing factor of this difference is supposed to be the distance from a fluoroscope. In addition to wear proper X-ray protective gears and reduce X-ray shooting time, we can further minimize radiation exposure by standing aside from the fluoroscope.

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Section: Discussionmentioning

confidence: 99%

Comparisons of the Amount of Radiation Exposure Among Medical Personnels in Percutaneous Vertebroplasty

Yu¹,

Lee²,

Shin³

et al. 2017

Asian J Pain

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“…A third protective measure is to operate the C-arm fluoroscopy in such a way as to minimize exposure. Using the pulsed and low-dose modes rather than conventional fluoroscopy, whenever possible, can reduce radiation doses [15-17]. …”

Section: Discussionmentioning

confidence: 99%

Radiation Exposure of the Hand and Chest during C-arm Fluoroscopy-Guided Procedures

et al. 2013

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BackgroundThe C-arm fluoroscope is an essential tool for the intervention of pain. The aim of this study was to investigate the radiation exposure experienced by the hand and chest of pain physicians during C-arm fluoroscopy-guided procedures.MethodsThis is a prospective study about radiation exposure to physicians during transforaminal epidural steroid injection (TFESI) and medial branch block (MBB). Four pain physicians were involved in this study. Data about effective dose (ED) at each physician's right hand and left side of the chest, exposure time, radiation absorbed dose (RAD), and the distance from the center of the X-ray field to the physician during X-ray scanning were collected.ResultsThree hundred and fifteen cases were included for this study. Demographic data showed no significant differences among the physicians in the TFESIs and MBBs. In the TFESI group, there was a significant difference between the ED at the hand and chest in all the physicians. In physician A, B and C, the ED at the chest was more than the ED at the hand. The distance from the center of the X-ray field to physician A was more than that of the other physicians, and for the exposure time, the ED and RAD in physician A was less than that of the other physicians. In the MBB group, there was no difference in the ED at the hand and chest, except for physician D. The distance from the center of the X-ray field to physician A was more than that of the other physicians and the exposure time in physician A was less than that of the other physicians.ConclusionsIn conclusion, the distance from the radiation source, position of the hand, experience and technique can correlate with the radiation dose.

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“…A decreased X-ray field from collimation reduces the overall integral dose to the patient, and thus minimizes the radiation risk of the patient and physician [9]. When clinicians do not need detailed image quality such as MBB, they can use the pulsed and low-dose modes together to reduce the radiation exposure [10]. However, the use of pulsed and/or low-dose modes can decrease the image quality.…”

Section: Discussionmentioning

confidence: 99%

A Randomized Controlled Trial about the Levels of Radiation Exposure Depends on the Use of Collimation C-arm Fluoroscopic-guided Medial Branch Block

et al. 2013

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BackgroundC-arm fluoroscope has been widely used to promote more effective pain management; however, unwanted radiation exposure for operators is inevitable. We prospectively investigated the differences in radiation exposure related to collimation in Medial Branch Block (MBB).MethodsThis study was a randomized controlled trial of 62 MBBs at L3, 4 and 5. After the patient was laid in the prone position on the operating table, MBB was conducted and only AP projections of the fluoroscope were used. Based on a concealed random number table, MBB was performed with (collimation group) and without (control group) collimation. The data on the patient's age, height, gender, laterality (right/left), radiation absorbed dose (RAD), exposure time, distance from the center of the field to the operator, and effective dose (ED) at the side of the table and at the operator's chest were collected. The brightness of the fluoroscopic image was evaluated with histogram in Photoshop.ResultsThere were no significant differences in age, height, weight, male to female ratio, laterality, time, distance and brightness of fluoroscopic image. The area of the fluoroscopic image with collimation was 67% of the conventional image. The RAD (29.9 ± 13.0, P = 0.001) and the ED at the left chest of the operators (0.53 ± 0.71, P = 0.042) and beside the table (5.69 ± 4.6, P = 0.025) in collimation group were lower than that of the control group (44.6 ± 19.0, 0.97 ± 0.92, and 9.53 ± 8.16), resepectively.ConclusionsCollimation reduced radiation exposure and maintained the image quality. Therefore, the proper use of collimation will be beneficial to both patients and operators.

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A Study to Compare the Radiation Absorbed Dose of the C-arm Fluoroscopic Modes

Cited by 34 publications

References 13 publications

Comparisons of the Amount of Radiation Exposure Among Medical Personnels in Percutaneous Vertebroplasty

Comparisons of the Amount of Radiation Exposure Among Medical Personnels in Percutaneous Vertebroplasty

Radiation Exposure of the Hand and Chest during C-arm Fluoroscopy-Guided Procedures

A Randomized Controlled Trial about the Levels of Radiation Exposure Depends on the Use of Collimation C-arm Fluoroscopic-guided Medial Branch Block

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