Mini C-Arm Fluoroscopy: Does Its Configuration Matter for Radiation Exposure to the Surgeon? | Semantic Scholar (2024)

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Mini C-Arm Fluoroscopy: Does Its Configuration Matter for Radiation Exposure to the Surgeon? | Semantic Scholar? ›

No significant difference was found to radiation exposure to the thyroid, chest, and groin between the 3 configurations, and relatively low levels of radiation were observed throughout. Figure 4. Relative to the configuration of the mini C-arm beam, hand radiation exposure was greatest in the horizontal position.

This study does suggest that use of the mini C-arm in hand surgery is safe, exposing the hand surgeon to minimal radiation. Assuming worst-case scenario, that each ring measured 29 mrem (just below the threshold), the surgeon's hands experienced at most 2.7 mrem per case.

Contrast dye moves through the catheter into the blood vessels. The fluoroscopy shows how the blood moves through the vessels and allows the healthcare provider to locate any blockages. Fluoroscopy procedures involve exposure to ionizing radiation that can slightly increase the risk of developing cancer later in life.

Position of the C Arm - The intensity of scatter radiation is the maximum in backward direction in orthopaedic procedures. The amount of scatter radiation to the surgeon is maximum in horizontal fluoroscopy and that is why it was proposed that the beam should be directed from medial to lateral direction [16,19].

With ionising radiation produced by a standard C-arm, this is roughly equal to equivalent doses of 0.113 μSv per lateral image and 0.043 μSv per PA image 16. Keenan et al. 26 found even lower levels in a simulated manipulation of a child's forearm using a manikin with scatter properties similar to human tissue.

Lead aprons, lead gloves, lead neck or thyroid shields, lead eyeglasses, lead drapes, and lead glass barriers help reduce radiation exposure for personnel. A lead barrier of 0.25-mm lead equivalent thickness typically stops 90% of x-rays, and a 0.5-mm lead equivalent apron typically absorbs 97% of x-rays.

Uncertified fluoroscopic equipment is limited to a maximum exposure rate of 10 R/min. The fluoroscopic exposure rate in automatic and/or manual mode must not exceed 5 R/min when measured with a patient equivalent phantom composed of 1 inches of Type 1100 aluminum and 0.5 mm of copper or an equivalent device.

Surgical staff members may be repeatedly exposed to low levels of ionizing radiation over the course of their careers. Adverse health effects, such as cancer, may occur years following such exposure.

Minimization of fluoroscopy time has been proven to be one of the most effective ways of reducing radiation dose to the patient and staff during fluoroscopy. Experience has shown that a substantial reduction in patient dose may be achieved by limiting the fluoroscopy time.

The researchers found that the average occupational dose per year across all types of staff was 0.48 mSv; it was 0.6 mSv for radiologic technologists. They also found that the effective dose for radiologists and technologists were 0.74 and 3.76 mSv, respectively.

How far from C-arm is safe? ›

What Is a Safe Distance When Using a Mini C-Arm? The rule of thumb is to maintain as much distance as feasibly possible. Radiation intensity decreases exponentially with distance. In general, standing 3.5 feet (around 1 meter) away from the source can reduce radiation exposure by about 90%.

While radiography and fixed fluoroscopy machines produce static images, C-arm machines provide real-time imaging during procedures. This makes them invaluable in surgeries where precision is crucial.

Lymphocytes (white blood cells) and cells which produce blood are constantly regenerating, and are, therefore, the most sensitive. Reproductive and gastrointestinal cells are not regenerating as quickly and are less sensitive.

Surgeons wear lead aprons or other protective gear, such as lead gloves and thyroid shields, in certain medical procedures involving X-ray or fluoroscopy. The reason for this protective gear is to shield the surgeon from exposure to ionizing radiation, which can be harmful in high doses.

Radiation from a C-arm machine primarily emanates directly from the X-ray tube and indirectly from the patient as scattered radiation. The X-ray tube is housed in the bottom of the C-arm, while scattering occurs when X-rays interact with the patient's tissues during procedures.

During a typical fluoroscopic procedure, the skin radiation dose is between 2 and 5 rad/min (0.02 and 0.05 Gy/min). However, doses as high as 5 rad/min (0.5 Gy/min) have been documented. As in the present case, most of the reported cases of FICRD are due to cardiac procedures.

Radiation exposure comes from 3 major sources in the fluoroscopic suite, including the primary X-ray beam and leakage and scattered X-ray beams.

The most common 0.5 mm lead equivalent aprons used by the staff during fluoroscopy attenuate 95% of the scattered radiation to the shielded torso, vs 80% for the lightweight 0.25 mm aprons. After a lead apron, leaded thyroid shields and eyeglasses provide additional protection in descending order.

Overall, physicians' radiation exposure was 3.7 to 10 times lower during CT-guided spinal injections than it was during fluoroscopy-guided injections (P<0.03).