Korean J Pain.  2011 Dec;24(4):199-204. 10.3344/kjp.2011.24.4.199.

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

• Cho JH
• Kim JY
• Kang JE
• Park PE
• Kim JH
• Lim JA
• Kim HK
• Woo NS

• KMID: 2074014
• DOI: http://doi.org/10.3344/kjp.2011.24.4.199

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.

Keyword

fluoroscopy; radiation; radiation dosage; radiographic image enhancement

MeSH Terms

Fluoroscopy
Humans
Organothiophosphorus Compounds
Radiation Dosage
Radiographic Image Enhancement
Organothiophosphorus Compounds

Figure

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  Fig. 1 The lead apron (0.85 mm lead equivalent thickness) was on the table and the X-ray tube was positioned below the apron and the detector above the apron.

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  Fig. 2 Comparison of time, radiation-absorbed doses (RADs), mean RADs/mean time and current (mA) among modes by graphs. Pulsed fluoroscopic mode of 15 frames per second was used. *P < 0.05. †Unit is expressed as second in Time, mRADs/cm2 in RADs, mRADs/cm2 · second in RADs/Time, and mA in Current.

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  Fig. 3 Comparison of peak X-ray energy (kVp) among modes by graphs. Pulsed fluoroscopic mode of 15 frames per second was used. *P < 0.05.

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  Fig. 4 According to C-arm modes, four fluoroscopic images blocking lumbar medial branch nerves. (A) Convention mode. (B) Pulsed mode. (C) Low-dose mode. (D) Pulsed + low-dose mode.

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