New automated fluoroscopic systems for pediatric applications

Abstract

Pediatric patients are at higher risk to the adverse effects from exposure to ionizing radiation than adults. The smaller sizes of the anatomy and the reduced x-ray attenuation of the tissues provide special challenges. The goal of this effort is to investigate strategies for pediatric fluoroscopy in order to minimize the radiation dose to these individuals, while maintaining effective diagnostic image quality. Modern fluoroscopy systems are often entirely automated and computer controlled. In this paper, various selectable and automated modes have been examined to determine their influence of the fluoroscopy parameters upon the patient radiation doses and image quality. Some of these parameters include: variable x-ray beam filters, Automatic Brightness Control (ABC) programs, starting kVp levels, fluoroscopic pulse rates, and other factors. Typical values of radiation doses have been measured for a range of phantom thicknesses from 5 to 20 cm of acrylic. Other evaluations that have been assessed include: spatial resolution, low contrast discrimination and temporal resolution. The selection menu for the various procedures is based upon the examination type, anatomical region, and patient size. For pediatric patients, the automated system can employ additional filtration, special ABC curves, pulsed fluoroscopy, and other features to reduce the patient radiation doses without significantly compromising the image quality. The benefits gained from an optimal selection of automated programs and settings for fluoroscopy include ease of operation, better image quality, and lower patient radiation doses.