Dose reduction for fluoroscopically guided injections: phantom simulation and patient procedures.

Objective: To demonstrate fluoroscopy dose reduction through both simulated injections on a phantom and patient injections.Materials and Methods: Our study was IRB-approved and HIPAA-compliant. Simulation on a phantom was used to estimate effective dose, entrance dose, and organ doses for hip joint...

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Publicado en:Skeletal Radiology Vol. 47; no. 2; pp. 223 - 232
Autores principales: Chang, C. Y., Simeone, F. J., DeLorenzo, M. C., Palmer, W. E., Bredella, M. A., Huang, A. J.
Formato: Journal Article
Publicado: Springer Nature Feb2018
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: Dose reduction for fluoroscopically guided injections: phantom simulation and patient procedures.
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          Chang, C. Y.
          Simeone, F. J.
          DeLorenzo, M. C.
          Palmer, W. E.
          Bredella, M. A.
          Huang, A. J.
        affil: Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street Yawkey 6E, 02114, Boston, MA, USA
      sug:
        subj:
          Injections, Intraarticular
          Fluoroscopy Methods
          Radiologic Health Methods
          Child
          Female
          Aged
          Phantoms, Imaging
          Aged, 80 and Over
          Hip Joint
          Retrospective Design
          Adolescence
          Adult
          Middle Age
          Radiation Dosage
          Male
          Child: 6-12 years
          Aged: 65+ years
          Aged, 80 & over
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Objective: To demonstrate fluoroscopy dose reduction through both simulated injections on a phantom and patient injections.Materials and Methods: Our study was IRB-approved and HIPAA-compliant. Simulation on a phantom was used to estimate effective dose, entrance dose, and organ doses for hip joint injections without and with dose minimization technique (DMT). Additionally, 1,094 joint, bursae, and tendon sheath injections performed by three operators in the same fluoroscopy suite were evaluated both before and after application of DMT. Fluoroscopy time (FT), dose, and dose area product (DAP) of injections were compared using unpaired t-tests with P > 0.05 considered statistically significant.Results: For the phantom simulation comparing injections without DMT and with DMT, the total DAP was 191.7 vs 18.7 μGy·m2, and the entrance dose was 10.2 vs 3.6 mGy, respectively. For both men and women, DMT reduces effective dose and organ doses. For all injections, the FT (0.7 to 0.2 min), dose (5.6 to 1.9 mGy), and DAP (56.9 to 19.1 μGy·m2) for all three operators decreased with DMT and remained statistically significant when stratified by the two most common injections, glenohumeral and hip joint injections (P < 0.05).Conclusions: FT, effective dose, entrance dose, and DAP can be reduced with the use of simple easy-to-learn techniques, which will benefit both the patient and the radiologist.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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