MP63-05 FLUOROSCOPY PULSE RATE AND RADIATION ABSORBED DOSE DEMONSTRATE A NEAR-PERFECT LINEAR CORRELATION

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology IV1 Apr 2018MP63-05 FLUOROSCOPY PULSE RATE AND RADIATION ABSORBED DOSE DEMONSTRATE A NEAR-PERFECT LINEAR CORRELATION Todd Yecies, Michelle Semins, Michael Sheetz, Mark Durango, and Rajeev Chaudhry Todd YeciesTodd Yecies More articles by this author , Michelle SeminsMichelle Semins More articles by this author , Michael SheetzMichael Sheetz More articles by this author , Mark DurangoMark Durango More articles by this author , and Rajeev ChaudhryRajeev Chaudhry More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2028AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Modern fluoroscopy units have multiple settings that can be modified to lower radiation exposure, including the use of low-dose and pulsed fluoroscopy. Studies have demonstrated that reducing pulse rate yields reductions in radiation dose that are less then would be expected if pulse rate and radiation dose had a linear relationship. It is unclear to what extent this finding stems from automated exposure adjustments performed by C-arm devices, changes in surgeon behavior, or limitations in using proxy measurements such as fluoroscopy time or C-arm reported dose. We aimed to identify the relationship between fluoroscopy pulse rate and radiation absorbed dose (AD) in a controlled setting with equivalent exposure behaviors. METHODS Using a simulated patient model, 60 second stopwatch timed fluoroscopy exposures were performed using pulse rates of 30, 8, 4, 2, and 1 pulse(s) per second (pps). Each experiment was performed with both standard and low-dose settings using a GE OEC 9800 plus C-arm. Landauer nanoDotTMOSL dosimeters were used to measure AD. The relationship between AD, fluoroscopy pulse rate, and proxy measurements including fluoroscopy time and C-arm reported dose was evaluated for standard and low-dose settings. RESULTS Fluoroscopy pulse rate and AD demonstrated a near-perfect linear correlation for both standard (R2=0.995) and low-dose (R2=0.998) settings. For any given pulse rate, using the low-dose setting reduced AD by 58±2.8%. Fluoroscopy time demonstrated a linear relationship with AD for both standard (R2=0.996) and low-dose (R2=0.990) settings; however, fluoroscopy time did not change with the use of the low-dose setting. C-arm reported dose correlated linearly with AD (R2=0.999) but consistently under-estimated measured values by an average of 49±3.5%. Using, a combination of 1pps and low-dose fluoroscopy reduced AD by 97.7±0.1% CONCLUSIONS With equivalent exposure times, AD decreases linearly with fluoroscopy pulse rate. While fluoroscopy time correlates with AD, it does not account for the effect of the low-dose setting. These findings allow for surgeons to make an informed decision when selecting fluoroscopy settings to optimize the trade-off between radiation exposure and image quality during endourologic procedures. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e842 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Todd Yecies More articles by this author Michelle Semins More articles by this author Michael Sheetz More articles by this author Mark Durango More articles by this author Rajeev Chaudhry More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...