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

Abstract

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.

Review of the Clinical Use of Fluoroscopy in Hand Surgery

“…28,29) More experienced operators are likely to have shorter surgical times, a more targeted approach and more precise planning and execution of imaging. When a surgeon is positioning and operating the fluoroscopy unit, accidental imaging of the surgeon's hands is much less likely occur than if it is operated by a radiographer.…”

Are Doctors Exposed to Radiation Even When Wearing Protectors during Fluoroscopic Procedures?

“…I enjoyed the article titled "Radiation Exposure of the Hand and Chest during C-arm Fluoroscopy-Guided Procedures" [1]. It is generally agreed that the hazards of radiation during fluoroscopic procedures can affect doctors as well as patients [2-4].…”

Replay to the Letter: Are Doctors Exposed to Radiation Even When Wearing Protectors during Fluoroscopic Procedures?

“…I appreciate your interest in and comments on the article titled "Radiation Exposure of the Hand and Chest during C-arm Fluoroscopy-Guided Procedures" [1]. In this study, the distance from the center of the X-ray field to the physician was the distance from the axis between the tube and intensifier to the physician.…”