Radiation Exposure of the Hand and Chest during C-arm Fluoroscopy-Guided Procedures

Abstract

Background: The C-arm fluoroscope is an essential tool for the intervention of pain. The aim of this study was to investigate the radiation exposure experienced by the hand and chest of pain physicians during C-arm fluoroscopy-guided procedures.

Methods: This is a prospective study about radiation exposure to physicians during transforaminal epidural steroid injection (TFESI) and medial branch block (MBB). Four pain physicians were involved in this study. Data about effective dose (ED) at each physician's right hand and left side of the chest, exposure time, radiation absorbed dose (RAD), and the distance from the center of the X-ray field to the physician during X-ray scanning were collected.

Results: Three hundred and fifteen cases were included for this study. Demographic data showed no significant differences among the physicians in the TFESIs and MBBs. In the TFESI group, there was a significant difference between the ED at the hand and chest in all the physicians. In physician A, B and C, the ED at the chest was more than the ED at the hand. The distance from the center of the X-ray field to physician A was more than that of the other physicians, and for the exposure time, the ED and RAD in physician A was less than that of the other physicians. In the MBB group, there was no difference in the ED at the hand and chest, except for physician D. The distance from the center of the X-ray field to physician A was more than that of the other physicians and the exposure time in physician A was less than that of the other physicians.

Conclusions: In conclusion, the distance from the radiation source, position of the hand, experience and technique can correlate with the radiation dose.

Keywords: distance; exposure time; radiation dose; radiation protection.

Fig. 1

Two dosimeters were used to record the radiation exposure. (A) One was worn on the left chest over the lead apron. (B) The other was worn on the palmar aspect of the right hand. Circle: detector of dosimeter.

Fig. 2

Various position of hands during X-ray scanning. (A) Physician A's position, (B) Physician B and C's position, (C) Physician D's position.

Fig. 3

The positions of each physician's hand which was looked down. (A) Physician A's position, (B) Physician B and C's position, (C) Physician D's position.