Radiation dose reduction in paediatric fluoroscopy using added filtration

Abstract

Studies on a water phantom indicate that the insertion of extra tube filtration combined with the removal of the antiscatter grid can reduce the total energy imparted from paediatric fluoroscopy by a factor of more than four when automatic exposure control is used. The omission of the grid is responsible for up to 40% of the reduction while the addition of 0.7 mm steel filtration is found to account for a further reduction in energy imparted of between 57% and 70%, for depths of water simulating small patients of 6-16 cm thickness. For all contrast paediatric examinations the reduction in image quality was considered to be small and the diagnostic information unimpaired with the filter in place.

Dose and image quality in the comparison of analogue and digital techniques in paediatric urology examinations

“…Added filtration together with a removal of the grid was found to reduce the dose a factor of 4 when automatic exposure control was used. The image quality reduction was considered to be small and the loss of diagnostic information unimpaired [11]. Potential dose savings of up to 85% were found when using carbon fibre cassettes, modern image intensifier, increasing film-screen sensitivity, collimation and higher kilovoltage in radiographs [12].…”

Added copper filtration in digital paediatric double-contrast colon examinations: effects on radiation dose and image quality

“…A similar investigation has recently been published by Nicholson et al [2] who measured the dose reduction Abstract. Paediatric double-contrast barium enema examinations are usually performed at high tube voltage, 102-105 kV.…”

“…The equipment is mainly used for examinations of the abdomen and bladder and offers the possibility to select the beam filtration in four steps by adding different thicknesses of copper (Cu) during both fluoroscopy and fluorography. Previous studies of suitable materials for spectral shaping have shown that Cu is a good choice compared with K-edge filters regarding both image quality, tube loading, dose reduction and price [3,8,9].The aim of this study was to investigate how much the effective dose could be reduced when adding Cu filter in the beam for a colon examination, and if this dose reduction could be achieved without endangering the image quality needed for accurate diagnosis.A similar investigation has recently been published by Nicholson et al [2] who measured the dose reduction Abstract. Paediatric double-contrast barium enema examinations are usually performed at high tube voltage, 102-105 kV.…”

“…The attributable lifetime risk for fatal cancer per absorbed dose is 14 % per Sv for exposures between ages 0 and 9 years compared with 4 % per Sv at the age of 30 years as given by ICRP 60 [1].It has been shown in several studies that by increasing the filtration of the beam or the tube voltage it is possible to reduce the entrance dose to the patient, both in children and adults [2][3][4][5][6][7][8][9]. This often large reduction in the skin dose leads to a smaller reduction in the effective dose due to increased depth dose with higher mean energy of the X-ray spectrum [4].…”

Comparison of pediatric radiation dose and vessel visibility on angiographic systems using piglets as a surrogate: antiscatter grid removal vs. lower detector air kerma settings with a grid — a preclinical investigation

“…To this end, numerous authors over a number of years have recommended removing the antiscatter grid from the X‐ray beam during fluoroscopic examinations of small children 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 . While some authors have quantified the reduction in patient dose to these pediatric patients, 7 , 13 , 16 , 17 , 18 , 19 the loss of image quality associated with this reduction in patient dose has been measured only on a limited basis 7 , 9 , 14 , 16 , 17 , 20 with phantoms as opposed to live models.…”