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Original research article


Radiation Reduction in Low Dose Pulsed Fluoroscopy versus Standard Dose Continuous Fluoroscopy during Fluoroscopically-Guided Lumbar Punctures: A Prospective Controlled Study

Shyam SabatEinat Slonimsky
Department of Radiology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
Date of Submission: 29-Dec-2017, Date of Acceptance: 01-Feb-2018, Date of Web Publication: 09-Mar-2018.
Corresponding Author:
Corresponding Author

Shyam Sabat

Department of Radiology, H066, Penn State Milton S Hershey Medical Center, Hershey, PA 17033, USA.
E-mail: ssabat@pennstatehealth.psu.edu

Corresponding Author:
Corresponding Author

Shyam Sabat

Department of Radiology, H066, Penn State Milton S Hershey Medical Center, Hershey, PA 17033, USA.
E-mail: ssabat@pennstatehealth.psu.edu

DOI: 10.4103/jcis.JCIS_94_17 Facebook Twitter Google Linkedin

ABSTRACT



Purpose:The purpose of this study was to evaluate radiation dose reduction in fluoroscopically guided lumbar punctures (FGLP) using “pulsed fluoroscopy in a low dose mode” compared with the commonly used “continuous fluoroscopy in a standard dose mode” while maintaining the technical success.
Materials and Methods: Thirty-five consecutive patients who underwent FGLP divided randomly to seventeen patients in the control group with standard dose continuous FGLP and eighteen patients in the study group with low-dose low-frame-rate of 3 frames per second (fps) FGLP. Entrance surface dose measurements from a dosimeter device were recorded as well as the dose area product (DAP).
Results: A total of 35 patients with average age of 52 years (range: 15–87 [±17 standard deviation [SD]]) were evaluated. Average entrance surface dose of the study group was significantly lower (3.81 mGy [range: 0.21–11.14, [±2.8 SD]]) compared with the control group (22.45 mGy [range: 1.23–73.44, [±19.41 [SD]]). The average DAP of the study group (10 mGy·cm2 [range: 1–41, [±9.8 SD]]) was also significantly lower than the control group (65 mGy·cm2 [range: 5–199, [±53 SD]]). Success rate was similar between the study and control groups.
Conclusion: Low dose pulsed fluoroscopy of 3 fps significantly reduces radiation exposure by about 600% compared with standard dose continuous fluoroscopy in FGLP. Utilizing this radiation saving strategy will allow to dramatically reduce radiation exposure, without impacting the technical success rate.
Keywords: Fluoroscopy, lumbar puncture, radiation

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