A Randomized Controlled Trial about the Levels of Radiation Exposure Depends on the Use of Collimation C-arm Fluoroscopic-guided Medial Branch Block
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초록
Background:C-arm fluoroscope has been widely used to promote more effective pain management; however, unwanted radiation exposure for operators is inevitable. We prospectively investigated the differences in radiation exposure related to collimation in Medial Branch Block (MBB). Methods:This study was a randomized controlled trial of 62 MBBs at L3, 4 and 5. After the patient was laid in the prone position on the operating table, MBB was conducted and only AP projections of the fluoroscope were used. Based on a concealed random number table, MBB was performed with (collimation group) and without (control group) collimation. The data on the patient’s age, height, gender, laterality (right/left), radiation absorbed dose (RAD), exposure time, distance from the center of the field to the operator, and effective dose (ED) at the side of the table and at the operator’s chest were collected. The brightness of the fluoroscopic image was evaluated with histogram in Photoshop. Results:There were no significant differences in age, height, weight, male to female ratio, laterality, time, distance and brightness of fluoroscopic image. The area of the fluoroscopic image with collimation was 67% of the conventional image. The RAD (29.9 ± 13.0, P = 0.001) and the ED at the left chest of the operators (0.53 ± 0.71, P = 0.042) and beside the table (5.69 ± 4.6, P = 0.025) in collimation group were lower than that of the control group (44.6 ± 19.0, 0.97 ± 0.92, and 9.53 ± 8.16), resepectively. Conclusions:Collimation reduced radiation exposure and maintained the image quality. Therefore, the proper use of collimation will be beneficial to both patients and operators.
Abstract
Background:C-arm fluoroscope has been widely used to promote more effective pain management; however, unwanted radiation exposure for operators is inevitable. We prospectively investigated the differences in radiation exposure related to collimation in Medial Branch Block (MBB). Methods:This study was a randomized controlled trial of 62 MBBs at L3, 4 and 5. After the patient was laid in the prone position on the operating table, MBB was conducted and only AP projections of the fluoroscope were used. Based on a concealed random number table, MBB was performed with (collimation group) and without (control group) collimation. The data on the patient’s age, height, gender, laterality (right/left), radiation absorbed dose (RAD), exposure time, distance from the center of the field to the operator, and effective dose (ED) at the side of the table and at the operator’s chest were collected. The brightness of the fluoroscopic image was evaluated with histogram in Photoshop. Results:There were no significant differences in age, height, weight, male to female ratio, laterality, time, distance and brightness of fluoroscopic image. The area of the fluoroscopic image with collimation was 67% of the conventional image. The RAD (29.9 ± 13.0, P = 0.001) and the ED at the left chest of the operators (0.53 ± 0.71, P = 0.042) and beside the table (5.69 ± 4.6, P = 0.025) in collimation group were lower than that of the control group (44.6 ± 19.0, 0.97 ± 0.92, and 9.53 ± 8.16), resepectively. Conclusions:Collimation reduced radiation exposure and maintained the image quality. Therefore, the proper use of collimation will be beneficial to both patients and operators.
참고문헌 (13)
- Fink GE, "Radiation safety in fluoroscopy for neuraxial injections", AANA J, 77, pp.265~269 (2009)
- Singer G, "Occupational radiation exposure to the surgeon", J Am Acad Orthop Surg, 13, pp.69~76 (2005)
- Miller DL, "Occupational radiation protection in interventional radiology: a joint guideline of the Cardiovascular and Interventional Radiology Society of Europe and the Society of Interventional Radiology", J Vasc Interv Radiol, 21, pp.607~615 (2010)
- Le Heron J, "Radiation protection of medical staff", Eur J Radiol, 76, pp.20~23 (2010)
- Killewich LA, "Governmental regulations and radiation exposure", J Vasc Surg, 53, pp.44S~46S (2011)
- Pyong Eun Park, "Radiation Safety and Education in the Applicants of the Final Test for the Expert of Pain Medicine", The Korean Journal of Pain, 25(1), pp.16~21 (2012), 대한통증학회
- Botwin KP, "Radiation exposure to the physician performing fluoroscopically guided caudal epidural steroid injections", Pain Physician, 4, pp.343~348 (2001)
- 정우경, "투시와 중재시술의 방사선 피폭과 저감화 방법", 대한의사협회지, 54(12), pp.1269~1276 (2011), 대한의사협회
- Poletti JL, "The effect of source to image-receptor distance on effective dose for some common X-ray projections", Br J Radiol, 78, pp.810~815 (2005)
- Jae Hun Cho, "A Study to Compare the Radiation Absorbed Dose of the C-arm Fluoroscopic Modes", The Korean Journal of Pain, 24(4), pp.199~204 (2011), 대한통증학회
- Powys R, "Strict X-ray beam collimation for facial bones examination can increase lens exposure", Br J Radiol, 85, pp.e497~e505 (2012)
- Rathmell JP, "Radiation safety, In Atlas of image-guided intervention in regional anesthesia and pain medicine", pp.8~15 (2006), Lippincott Williams & Wilkins
- Walters TE, "Impact of collimation on radiation exposure during interventional electrophysiology", Europace, 14, pp.1670~1673 (2012)