Radiation Reduction in Low Dose Pulsed Fluoroscopy versus Standard Dose Continuous Fluoroscopy during Fluoroscopically-Guided Lumbar Punctures: A Prospective Controlled Study.

Abstract

Purpose:The purpose of this study was to evaluate radiation dose reduction in fluoroscopically guided lumbar punctures (FGLP) using “pulsed fluoroscopy in a low dose mode” compared with the commonly used “continuous fluoroscopy in a standard dose mode” while maintaining the technical success.Materials and Methods:Thirty-five consecutive patients who underwent FGLP divided randomly to seventeen patients in the control group with standard dose continuous FGLP and eighteen patients in the study group with low-dose low-frame-rate of 3 frames per second (fps) FGLP. Entrance surface dose measurements from a dosimeter device were recorded as well as the dose area product (DAP).Results:A total of 35 patients with average age of 52 years (range: 15–87 [±17 standard deviation [SD]]) were evaluated. Average entrance surface dose of the study group was significantly lower (3.81 mGy [range: 0.21–11.14, [±2.8 SD]]) compared with the control group (22.45 mGy [range: 1.23–73.44, [±19.41 [SD]]). The average DAP of the study group (10 mGy·cm2 [range: 1–41, [±9.8 SD]]) was also significantly lower than the control group (65 mGy·cm2 [range: 5–199, [±53 SD]]). Success rate was similar between the study and control groups.Conclusion:Low dose pulsed fluoroscopy of 3 fps significantly reduces radiation exposure by about 600% compared with standard dose continuous fluoroscopy in FGLP. Utilizing this radiation saving strategy will allow to dramatically reduce radiation exposure, without impacting the technical success rate.