Purpose
This study tests the conventional wisdom that using fluoroscopy under identical geometrical
conditions results in less radiation when using the mini C-arm relative to the large
C-arm.
Methods
We evaluated the radiation dose for both direct exposure and scatter 2.54 cm outside
the intensifier. We used 3 mini and 3 large C-arms in a vertical orientation with
the image intensifier below the specimen and the source above. We used 2 specimens:
a cadaver hand/wrist and a cadaver elbow. Specimens were tested both directly on the
intensifier and on a hand table placed on the intensifier.
Results
For the same setup, use of the mini C-arm resulted in direct patient radiation exposure
greater than the exposure delivered by the large C-arm. Specifically, exposure using
the mini C-arm was 53% to 70% greater than that using the large C-arm. In addition,
use of the hand table resulted in exposure 80% to 94% greater compared with placing
the specimen directly on the intensifier. In all cases, scatter at 2.54 cm from the
intensifier resulted in an average exposure of 1.5% (SD, 0.24%) of the direct beam.
Tube current, and therefore machine radiation output, was approximately 13 to 14 times
greater for the large C-arm.
Conclusions
Direct radiation exposure to the patient and scatter to the surgeon are minimized
when the C-arm is positioned with the intensifier below and the extremity is placed
directly on the intensifier. Under identical geometrical conditions with the intensifier
below the specimen, the large C-arm with its greater source to image intensifier distance
is associated with less radiation exposure than the mini C-arm.
Key words
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References
- Cervical spine imaging using mini-C-arm fluoroscopy: patient and surgeon exposure to direct and scatter radiation.J Spinal Disord Tech. 2009; 22: 399-403
- Patient and surgeon radiation exposure: comparison of standard and mini-C-arm fluoroscopy.J Bone Joint Surg. 2009; 91A: 297-304
- Radiation exposure in hand surgery: mini versus standard C-arm.J Hand Surg. 2005; 30A: 1310-1316
- Radiation exposure to the hands from mini C-arm fluoroscopy.J Hand Surg. 2005; 30A: 795-797
Article info
Publication history
Published online: March 17, 2011
Accepted:
January 7,
2011
Received:
April 28,
2010
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
