Hysterosalpingography with use of mobile C-arm fluoroscopy

Abstract

To review radiation exposure during hysterosalpingography (HSG) examinations with use of a mobile C-arm fluoroscopic imaging system with advanced features including pulsed fluoroscopy and last-image-hold capability. Retrospective clinical study. Freestanding outpatient radiology office. Two hundred consecutive patients who were referred for HSG examinations to evaluate fertility or status of tubal ligation. Pulsed fluoroscopy (eight frames per second) and continuous fluoroscopy were used with automated exposure control and last image hold for static image capture. Fluoroscopy time (seconds), field of view (12 in., 9 in., 6 in.), mode (continuous, pulsed), and dose area product (mGycm(2)) were recorded for each patient. The total estimated surface dose then was calculated. One hundred forty-seven patients had normal results on hysterosalpingograms, and 57 patients had abnormal results on hysterosalpingograms. Selective salpingography was performed in 26 of the 38 patients with fallopian tube occlusions. Mean fluoroscopy time for normal, abnormal, and selective catheterization was 4.17, 14.3, and 56.1 seconds, respectively. Mean estimated surface dose for normal, abnormal, and selective catheterization was 2.6, 6.9, and 46.7 mGy, respectively. A mobile C-arm fluoroscopic imaging system with pulsed fluoroscopy and last-image-hold capability may be a desirable alternative for HSG to achieve lower radiation exposure with improved operator convenience and patient comfort.