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CT-guided lumbar nerve root injections: are we using the correct radiation dose settings?

Publication ,  Journal Article
Schauberger, JS; Kranz, PG; Choudhury, KR; Eastwood, JD; Gray, L; Hoang, JK
Published in: Ajnr Am J Neuroradiol
November 2012

BACKGROUND AND PURPOSE: Selecting a lower tube current for CT fluoroscopic spine injections is a method of radiation dose reduction. Ideally tube current should be tailored to the patient's body habitus, but a greater influence on tube current may be the proceduralist's personal preference. The purpose of this study was to compare tube current and fluoroscopy time of different proceduralists for lumbar spine CT-guided selective nerve root blocks, and to correlate image quality to patient diameter and tube current. MATERIALS AND METHODS: Eighty CT-guided SNRBs performed by 4 proceduralists were retrospectively reviewed for tube current and fluoroscopy time. Patient body habitus was evaluated by measuring anteroposterior diameters on scout images. Image quality was evaluated objectively and subjectively: noise was measured in the psoas muscle and images were graded on a 3-point scale. RESULTS: The mean tube current was 59 ± 20 mA and mean fluoroscopy time was 10.4 ± 7.5 seconds. The mean tube current between proceduralists differed by almost 2-fold, and there was greater than 2-fold difference in mean fluoroscopy time (P < .0001 and .01, respectively). Mean AP body size was 27 ± 5 cm. When categoric data of tube current and AP diameter were analyzed, only AP diameter was a statistically significant variable influencing image noise (P = .009). Twenty of 23 patients with AP diameter ≤30 cm had adequate to excellent image quality, even with lower tube current of ≤40 mA. CONCLUSIONS: Wide variability in tube current selection between proceduralists calls for a more objective method of selecting tube current to minimize radiation dose. Body size, measured by AP diameter, had the greatest influence on image quality. This could be used to identify patients for lower tube current selection.

Duke Scholars

Published In

Ajnr Am J Neuroradiol

DOI

EISSN

1936-959X

Publication Date

November 2012

Volume

33

Issue

10

Start / End Page

1855 / 1859

Location

United States

Related Subject Headings

  • Young Adult
  • Tomography, X-Ray Computed
  • Spinal Nerve Roots
  • Sensitivity and Specificity
  • Reproducibility of Results
  • Radiometry
  • Radiography, Interventional
  • Radiation Protection
  • Radiation Dosage
  • Nuclear Medicine & Medical Imaging
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Schauberger, J. S., Kranz, P. G., Choudhury, K. R., Eastwood, J. D., Gray, L., & Hoang, J. K. (2012). CT-guided lumbar nerve root injections: are we using the correct radiation dose settings? Ajnr Am J Neuroradiol, 33(10), 1855–1859. https://doi.org/10.3174/ajnr.A3096
Schauberger, J. S., P. G. Kranz, K. R. Choudhury, J. D. Eastwood, L. Gray, and J. K. Hoang. “CT-guided lumbar nerve root injections: are we using the correct radiation dose settings?Ajnr Am J Neuroradiol 33, no. 10 (November 2012): 1855–59. https://doi.org/10.3174/ajnr.A3096.
Schauberger JS, Kranz PG, Choudhury KR, Eastwood JD, Gray L, Hoang JK. CT-guided lumbar nerve root injections: are we using the correct radiation dose settings? Ajnr Am J Neuroradiol. 2012 Nov;33(10):1855–9.
Schauberger, J. S., et al. “CT-guided lumbar nerve root injections: are we using the correct radiation dose settings?Ajnr Am J Neuroradiol, vol. 33, no. 10, Nov. 2012, pp. 1855–59. Pubmed, doi:10.3174/ajnr.A3096.
Schauberger JS, Kranz PG, Choudhury KR, Eastwood JD, Gray L, Hoang JK. CT-guided lumbar nerve root injections: are we using the correct radiation dose settings? Ajnr Am J Neuroradiol. 2012 Nov;33(10):1855–1859.

Published In

Ajnr Am J Neuroradiol

DOI

EISSN

1936-959X

Publication Date

November 2012

Volume

33

Issue

10

Start / End Page

1855 / 1859

Location

United States

Related Subject Headings

  • Young Adult
  • Tomography, X-Ray Computed
  • Spinal Nerve Roots
  • Sensitivity and Specificity
  • Reproducibility of Results
  • Radiometry
  • Radiography, Interventional
  • Radiation Protection
  • Radiation Dosage
  • Nuclear Medicine & Medical Imaging