The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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A Study to Compare the Radiation Absorbed Dose of the C-arm Fluoroscopic Modes

  • Cho, Jae-Hun (Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center) ;
  • Kim, Jae-Yun (Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center) ;
  • Kang, Joo-Eun (Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center) ;
  • Park, Pyong-Eun (Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center) ;
  • Kim, Jae-Hun (Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center) ;
  • Lim, Jeong-Ae (Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center) ;
  • Kim, Hae-Kyoung (Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center) ;
  • Woo, Nam-Sik (Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center)
  • Received : 2011.10.28
  • Accepted : 2011.11.15
  • Published : 2011.12.01
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Abstract

Background: Although many clinicians know about the reducing effects of the pulsed and low-dose modes for fluoroscopic radiation when performing interventional procedures, few studies have quantified the reduction of radiation-absorbed doses (RADs). The aim of this study is to compare how much the RADs from a fluoroscopy are reduced according to the C-arm fluoroscopic modes used. Methods: We measured the RADs in the C-arm fluoroscopic modes including 'conventional mode', 'pulsed mode', 'low-dose mode', and 'pulsed + low-dose mode'. Clinical imaging conditions were simulated using a lead apron instead of a patient. According to each mode, one experimenter radiographed the lead apron, which was on the table, consecutively 5 times on the AP views. We regarded this as one set and a total of 10 sets were done according to each mode. Cumulative exposure time, RADs, peak X-ray energy, and current, which were viewed on the monitor, were recorded. Results: Pulsed, low-dose, and pulsed + low-dose modes showed significantly decreased RADs by 32%, 57%, and 83% compared to the conventional mode. The mean cumulative exposure time was significantly lower in the pulsed and pulsed + low-dose modes than in the conventional mode. All modes had pretty much the same peak X-ray energy. The mean current was significantly lower in the low-dose and pulsed + low-dose modes than in the conventional mode. Conclusions: The use of the pulsed and low-dose modes together significantly reduced the RADs compared to the conventional mode. Therefore, the proper use of the fluoroscopy and its C-arm modes will reduce the radiation exposure of patients and clinicians.

Keywords

References

  1. Raj PP, Lou L, Erdine S, Staats PS, Waldman SD, Racz G, et al. Interventional pain management: Image-guided procedures. 2nd ed. Philadelphia, Saunders Elsevier. 2008, p 11.
  2. Kim TW, Jung JH, Jeon HJ, Yoon KB, Yoon DM. Radiation exposure to physicians during interventional pain procedures. Korean J Pain 2010; 23: 24-7. https://doi.org/10.3344/kjp.2010.23.1.24
  3. Goodman BS, Carnel CT, Mallempati S, Agarwal P. Reduction in average fluoroscopic exposure times for interventional spinal procedures through the use of pulsed and low-dose image settings. Am J Phys Med Rehabil 2011 [Epub ahead of print]
  4. Cousins C, Sharp C. Medical interventional proceduresreducing the radiation risks. Clin Radiol 2004; 59: 468-73. https://doi.org/10.1016/j.crad.2003.11.014
  5. Mroz TE, Yamashita T, Davros WJ, Lieberman IH. Radiation exposure to the surgeon and the patient during kyphoplasty. J Spinal Disord Tech 2008; 21: 96-100. https://doi.org/10.1097/BSD.0b013e31805fe9e1
  6. Miller DL, Vañó E, Bartal G, Balter S, Dixon R, Padovani R, et al. Occupational radiation protection in interventional radiology: a joint guideline of the Cardiovascular and Interventional Radiology Society of Europe and the Society of Interventional Radiology. Cardiovasc Intervent Radiol 2010; 33: 230-9. https://doi.org/10.1007/s00270-009-9756-7
  7. Brown PH, Thomas RD, Silberberg PJ, Johnson LM. Optimization of a fluoroscope to reduce radiation exposure in pediatric imaging. Pediatr Radiol 2000; 30: 229-35. https://doi.org/10.1007/s002470050728
  8. Cohen MD. Can we use pulsed fluoroscopy to decrease the radiation dose during video fluoroscopic feeding studies in children? Clin Radiol 2009; 64: 70-3. https://doi.org/10.1016/j.crad.2008.07.011
  9. Cohen MD. Optimizing the use of pulsed fluoroscopy to reduce radiation exposure to children. J Am Coll Radiol 2008; 5: 205-9. https://doi.org/10.1016/j.jacr.2007.09.014
  10. Rathmell JP. Atlas of image-guided intervention in regional anesthesia and pain medicine. Philadelphia, Lippincott Williams & Wilkins. 2006, pp 9-15.
  11. Uppot RN, Sahani DV, Hahn PF, Kalra MK, Saini SS, Mueller PR. Effect of obesity on image quality: fifteen-year longitudinal study for evaluation of dictated radiology reports. Radiology 2006; 240: 435-9. https://doi.org/10.1148/radiol.2402051110
  12. Wagner LK, Archer BR, Cohen AM. Management of patient skin dose in fluoroscopically guided interventional procedures. J Vasc Interv Radiol 2000; 11: 25-33. https://doi.org/10.1016/S1051-0443(07)61274-3
  13. Aufrichtig R, Xue P, Thomas CW, Gilmore GC, Wilson DL. Perceptual comparison of pulsed and continuous fluoroscopy. Med Phys 1994; 21: 245-56. https://doi.org/10.1118/1.597285
  14. Brown PH, Silberberg PJ, Thomas RD, Strife JL, Towbin RB. A multihospital survey of radiation exposure and image quality in pediatric fluoroscopy. Pediatr Radiol 2000; 30: 236-42. https://doi.org/10.1007/s002470050729

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