Fluoroscopy is an x-ray medical imaging technique. It uses x-rays to produce real-time, moving images of a patient’s internal organs and structures with the aid of a fluoroscope, a device with a fluorescent screen that is used for viewing x-ray images in real time.

The simplest type of fluoroscopy setup is an x-ray source and a fluoroscope, with the patient placed between the two. However, many fluoroscopy setups couple the fluoroscope with an x-ray image intensifier and a video camera, allowing the fluoroscopy images to be recorded and played on a monitor. Modern flat-panel detectors eliminate the need for image intensifiers and have better sensitivity to x-rays, so they can ultimately reduce patient radiation dose during fluoroscopic x-ray medical imaging.

What Is Fluoroscopy Used for?

Fluoroscopy can be used to evaluate bones, muscles, joints, and solid organs like the lung, heart, or kidney. Barium x-rays, cardiac catheterization, lumbar puncture, placement of IV catheters, biopsies, and intravenous pyelograms are procedures where this type of imaging may be used. Fluoroscopy allows radiologists to view anatomical systems as they function, deriving more information than they would from traditional x-ray imagery.

Top Safety Concerns About Fluoroscopy

Fluoroscopy exposes patients to ionizing radiation, which is linked with cancer development. Therefore, it is important to keep radiation doses as low as possible during fluoroscopy procedures. Ensuring a fluoroscopy facility is safe requires several steps:

• Registration of the unit with regulating authorities
• Authorization of the facility by the appropriate authorities based on room size, shielding, staff training, and quality control procedures for radiation protection
• Conformity of the fluoroscopy system to International Electrotechnical Commission (IEC) or other appropriate national standards
• Testing of the system by a qualified medical physicist
• Periodic safety tests using protocols established by relevant professional organizations
• Monitoring of patient and staff radiation doses

Fluoroscopy procedures should be individually designed to minimize exposure of individual areas of the patient’s body to ionizing radiation, as well as minimizing total body dose of radiation.

Ways to Minimize X-ray Exposure for Patients

The time that the x-ray beam is on is one of the most important controllable factors in minimizing x-ray exposure for patients. Practitioners should use the shortest fluoroscopic times consistent with the requirements of the procedure. Records should be kept of exposure time for each procedure and patient.

With pulsed fluoroscopy (where fewer than the traditional 25 to 30 images per second are produced), use of equipment that allows the pulse rate to be set as low as practical can significantly reduce patient x-ray exposure. When using equipment with multiple modes of operation, high dose rate mode should only be used for the time in which a low-noise image is required.

Automatic brightness control (ABC) settings, field of view, and magnification settings also affect patient radiation dose with this type of x-ray medical imaging and should be considered carefully beforehand to minimize patient exposure. Selection of fluoroscopic time, beam limitation, and specific imaging modes should be done carefully so that sufficient images are obtained while keeping radiation doses to a minimum.

Ensuring the Best Results from Fluoroscopy

The keys for obtaining the best x-ray medical imaging results from fluoroscopy while maintaining patient safety have to do with the fluoroscopy equipment, and the skill and experience of those using it. Radiologists with experience in fluoroscopy know the equipment, and know how to position the patient and the x-ray tube optimally for best image quality and maximum safety.

Experienced radiologists and technicians keep records of fluoroscopy procedures for each patient and know the lowest frame rate that can be used that is consistent with high image quality. An understanding of how lateral views and oblique projections increase patient dose, and an understanding of how to vary the position where the beam enters the patient help these professionals obtain high quality medical imaging without compromising patient safety.

Count on SteleRAD for Quality Radiology Services

Fluoroscopy is a type of x-ray medical imaging with the potential to guide critical patient procedures affecting many systems of the body. When used by skilled and experienced professionals, high image quality is achieved while maintaining patient safety.

SteleRAD’s team of Board-certified, experienced radiologists can serve the fluoroscopy needs of hospitals, practices, and imaging centers. Uninterrupted access to radiological services is often critical to patient health, and SteleRAD has provided radiology services across a broad spectrum of sub-specialties to clients in the South Florida region for over 40 years. To learn more, contact SteleRAD online, or call 954-358-5250.