Scholars@Duke publication: Radiation dose exposure for lumbar spine epidural steroid injections: a comparison of conventional fluoroscopy data and CT fluoroscopy techniques.

Radiation dose exposure for lumbar spine epidural steroid injections: a comparison of conventional fluoroscopy data and CT fluoroscopy techniques.

Publication , Journal Article

Hoang, JK; Yoshizumi, TT; Toncheva, G; Gray, L; Gafton, AR; Huh, BK; Eastwood, JD; Lascola, CD; Hurwitz, LM

Published in: AJR Am J Roentgenol

October 2011

OBJECTIVE: The purpose of this article is to compare the radiation dose of conventional fluoroscopy-guided lumbar epidural steroid injections (ESIs) and CT fluoroscopy (CTF)-guided lumbar ESI using both clinical data and anthropomorphic phantoms. MATERIALS AND METHODS: We performed a retrospective review of dose parameters for 14 conventional fluoroscopy ESI procedures performed by one proceduralist and 42 CTF-guided ESIs performed by three proceduralists (14 each). By use of imaging techniques similar to those for our clinical cohorts, a commercially available anthropomorphic male phantom with metal oxide semiconductor field effect transistor detectors was scanned to obtain absorbed organ doses for conventional fluoroscopy-guided and CTF-guided ESIs. Effective dose (ED) was calculated from measured organ doses. RESULTS: The mean conventional fluoroscopy time for ESI was 37 seconds, and the mean procedural CTF time was 4.7 seconds. Calculated ED for conventional fluoroscopy was 0.85 mSv compared with 0.45 mSv for CTF. The greatest contribution to the radiation dose from CTF-guided ESI came from the planning lumbar spine CT scan, which had an ED of 2.90 mSv when z-axis ranged from L2 to S1. This resulted in a total ED for CTF-guided ESI (lumbar spine CT scan plus CTF) of 3.35 mSv. CONCLUSION: The ED for the CTF-guided ESI was almost half that of conventional fluoroscopy because of the shorter fluoroscopy time. However, the overall radiation dose for CTF-guided ESIs can be up to four times higher when a full diagnostic lumbar CT scan is performed as part of the procedure. Radiation dose reduction for CTF-guided ESI is best achieved by minimizing the dose from the preliminary planning lumbar spine CT scan.

Duke Scholars

Author Lynne Michelle Hurwitz Koweek Radiology, Cardiothoracic Imaging

Author Linda Gray Leithe Radiology, Neuroradiology

Author James D. Eastwood Radiology, Neuroradiology

Author Christopher David Lascola Radiology, Neuroradiology

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Published In

AJR Am J Roentgenol

DOI

10.2214/AJR.10.6102

EISSN

1546-3141

Publication Date

October 2011

Volume

197

Issue

Start / End Page

778 / 782

Location

United States

Related Subject Headings

Tomography, X-Ray Computed
Time Factors
Steroids
Retrospective Studies
Radiography, Interventional
Radiation Dosage
Phantoms, Imaging
Nuclear Medicine & Medical Imaging
Male
Lumbar Vertebrae

Citation

APA

Chicago

ICMJE

MLA

NLM

Hoang, J. K., Yoshizumi, T. T., Toncheva, G., Gray, L., Gafton, A. R., Huh, B. K., … Hurwitz, L. M. (2011). Radiation dose exposure for lumbar spine epidural steroid injections: a comparison of conventional fluoroscopy data and CT fluoroscopy techniques. AJR Am J Roentgenol, 197(4), 778–782. https://doi.org/10.2214/AJR.10.6102

Hoang, Jenny K., Terry T. Yoshizumi, Greta Toncheva, Linda Gray, Andreia R. Gafton, Billy K. Huh, James D. Eastwood, Christopher D. Lascola, and Lynne M. Hurwitz. “Radiation dose exposure for lumbar spine epidural steroid injections: a comparison of conventional fluoroscopy data and CT fluoroscopy techniques.” AJR Am J Roentgenol 197, no. 4 (October 2011): 778–82. https://doi.org/10.2214/AJR.10.6102.

Hoang JK, Yoshizumi TT, Toncheva G, Gray L, Gafton AR, Huh BK, et al. Radiation dose exposure for lumbar spine epidural steroid injections: a comparison of conventional fluoroscopy data and CT fluoroscopy techniques. AJR Am J Roentgenol. 2011 Oct;197(4):778–82.

Hoang, Jenny K., et al. “Radiation dose exposure for lumbar spine epidural steroid injections: a comparison of conventional fluoroscopy data and CT fluoroscopy techniques.” AJR Am J Roentgenol, vol. 197, no. 4, Oct. 2011, pp. 778–82. Pubmed, doi:10.2214/AJR.10.6102.

Hoang JK, Yoshizumi TT, Toncheva G, Gray L, Gafton AR, Huh BK, Eastwood JD, Lascola CD, Hurwitz LM. Radiation dose exposure for lumbar spine epidural steroid injections: a comparison of conventional fluoroscopy data and CT fluoroscopy techniques. AJR Am J Roentgenol. 2011 Oct;197(4):778–782.