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Imaging & Therapeutic Technology |
1 From The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, Baltimore, MD 21287. From the AAPM/RSNA Physics Tutorial at the 1999 RSNA scientific assembly. Received February 16, 2001; revision requested March 29 and received April 19; accepted April 23. Address correspondence to the author (e-mail: mmahesh@jhmi.edu).
Fluoroscopic procedures (particularly prolonged interventional procedures) may involve high patient radiation doses. The radiation dose depends on the type of examination, the patient size, the equipment, the technique, and many other factors. The performance of the fluoroscopy system with respect to radiation dose is best characterized by the receptor entrance exposure and skin entrance exposure rates, which should be assessed at regular intervals. Management of patient exposure involves not only measurement of these rates but also clinical monitoring of patient doses. Direct monitoring of patient skin doses during procedures is highly desirable, but current methods still have serious limitations. Skin doses may be reduced by using intermittent exposures, grid removal, last image hold, dose spreading, beam filtration, pulsed fluoroscopy, and other dose reduction techniques. Proper training of fluoroscopic operators, understanding the factors that influence radiation dose, and use of various dose reduction techniques may allow effective management of patient dose.
Index Terms: Dosimetry • Education • Fluoroscopy • Physics • Radiations, exposure to patients and personnel • Radiations, injurious effects • Radiations, measurement
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