Impact of flow pattern, body mass index, and age on intraprocedural fluoroscopic time and radiation dose during sacroiliac joint injections

Abstract

Purpose Understanding all factors that may impact radiation dose and procedural time is crucial to safe and efficient image-guided interventions, such as fluoroscopically guided sacroiliac (SI) joint injections. The purpose of this study was to evaluate the effect of flow pattern (intra- vs. periarticular), patient age, and body mass index (BMI) on radiation dose and fluoroscopy time. Methods A total of 134 SI joint injections were reviewed. Injectate flow pattern, age, and BMI were analyzed in respect to fluoroscopy time (minutes), radiation dose (kerma area product (KAP); µGy m2), and estimated skin dose (mGy). Results BMI did not affect fluoroscopy time, but increased BMI resulted in significantly higher skin and fluoroscopy doses ( p < 0.001). There was no association between fluoroscopy time and flow pattern. Higher skin dose was associated with intraarticular flow ( p = 0.0086), and higher KAP was associated with periarticular flow ( p = 0.0128). However, the odds ratios were close to 1. There was no significant difference between fluoroscopy time or dose based on patient age. Conclusion Increased BMI had the largest impact on procedural radiation dose and skin dose. Flow pattern also showed a statistically significant association with radiation dose and skin dose, but the clinical difference was small. Proceduralists should be aware that BMI has the greatest impact on fluoroscopy dose and skin dose during SI joint injections compared to other factors.