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. 2014 Oct 31;20(5):525-32.
doi: 10.15274/INR-2014-10043. Epub 2014 Oct 17.

Effect of Body Habitus on Radiation Dose During CT Fluoroscopy-Guided Spine Injections

Ronald J Viola  1 , Giao B Nguyen  2 , Terry T Yoshizumi  2 , Sandra S Stinnett  3 , Jenny K Hoang  2 , Peter G Kranz  2
Affiliations

Effect of Body Habitus on Radiation Dose During CT Fluoroscopy-Guided Spine Injections

Ronald J Viola et al. Interv Neuroradiol. .

Abstract

This study investigated the degree to which body habitus influences radiation dose during CT fluoroscopy (CTF)-guided lumbar epidural steroid injections (ESI). An anthropomorphic phantom containing metal oxide semiconductor field effect transistor (MOSFET) detectors was scanned at two transverse levels to simulate upper and lower lumbar CTF-guided ESI. Circumferential layers of adipose-equivalent material were sequentially added to model patients of three sizes: small (cross-sectional dimensions 25×30 cm), average (34×39 cm), and oversize (43×48 cm). Point dose rates to skin and internal organs within the CTF beam were measured. Scattered point dose rates 5 cm from the radiation beam were also measured. Direct point dose rates to the internal organs ranged from 0.05-0.11 mGy/10mAs in the oversized phantom, and from 0.18-0.43 mGy/10mAs in the small phantom. Skin direct point dose rates ranged from 0.69-0.71 mGy/10mAs in the oversized phantom and 0.88-0.94 mGy/10mAs in the small phantom. This represents a 180-310% increase in organ point dose rates and 24-36% increase in skin point dose rates in the small habitus compared with the oversize habitus. Scatter point dose rates increased by 83-117% for the small compared to the oversize phantom. Decreasing body habitus results in substantial increases in direct organ and skin point doses as well as scattered dose during simulated CTF-guided procedures. Failure to account for individual variations in body habitus will result in inaccurate dose estimation and inappropriate choice of tube current in CTF-guided procedures.

Keywords: CT fluoroscopy; body habitus; epidural injections; radiation dosimetry; spine therapy.

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Figures

Figure 1
Figure 1
Scout CT image of prone phantom demonstrating inner (*) and outer (**) layers of 4.5-cm-thick circumferential adipose-equivalent material. A single layer was applied to simulate average body habitus, and two layers were applied to simulate oversize habitus.
Figure 2
Figure 2
Experimental setup. A) Anthropomorphic phantom with MOSFET detectors positioned to detect exposure associated with upper and lower lumbar spine interventions. B) Phantom positioned prone in the scanner, with a single layer of simulated adipose tissue in place.
Figure 3
Figure 3
Point dose rates for each organ as a function of body habitus for the upper lumbar intervention. Note: error bars indicate standard deviation.
Figure 4
Figure 4
Point dose rates for each organ as a function of body habitus for the lower lumbar intervention. Note: error bars indicate standard deviation.
See this image and copyright information in PMC

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