Determination of Radiation Doses to Patients Undergoing Fluoroscopically Guided Orthopaedic Procedures at Muhimbili Orthopaedic Institute in Tanzania

The aim of the present study was to determine the magnitude of radiation doses delivered to patients undergoing Fluoroscopically Guided Orthopaedic Procedures (FGOP’s) in Tanzania. The air Kerma Area Product (KAP), fluoroscopy time, organ dose and effective dose to patients undergoing FGOP’s were obtained from Muhimbili Orthopaedic Institute. A total of 72 adult patients from selected three FGOPs namely Lumbar Spine (LS), Dynamic Hip Screw (DHS) and Thoracic Spine (TS) procedures were investigated using C-arm fluoroscopy machine. The knowledge of patient demographic data, radiographic data, KAP and Monte Carlo-based PCXMC software were used to obtain the magnitude of organ doses (OD) and effective doses (ED) of the patients. The median values of KAP for the LS, DHS and TS were 2.569, 2.410 and 0.770 Gy cm2, respectively. The mean values of ED for the LS, DHS, and TS procedures were 0.27, 0.47 and 2.70 mSv, respectively. The observed wide variations of KAP, organ dose, effective and exposure protocols within the hospital under study and relative high dose in this study compared to reported values from the literature call for standardization of procedural protocols and optimize fluoroscopically guided orthopaedic procedures. Keywords: Kerma-area-product; organ dose; effective dose; C-arm fluoroscopy machine; orthopaedic proceduresDetermination of Radiation Doses to Patients Undergoing Fluoroscopically Guided Orthopaedic Procedures at Muhimbili Orthopaedic Institute in Tanzani

Evaluation of the Influence of Additional Beam Filtration on Image Quality and Patient Dose in X-ray Fluoroscopy Procedures

The aim of the study was to evaluate the influence of additional filtration on radiation dose and image quality for patients during hysterosalpingography (HSG) and retrograde urethrography (RUG) procedures. The influence of filtering on image quality for each phantom thickness was made using a combination of different filter thicknesses. Entrance surface air kerma (ESAK) rates to Perspex phantom were measured using a solid state detector for various added combination of filter materials. Fluoroscopic image contrast was assessed using a Leeds TOR-18FG test object with a range of filter materials and phantom thicknesses. Phantom studies demonstrated that the use of additional filter materials of up to 0.35 mm thickness of copper could be used without significant effect on the image quality. ESAK values were determined for 16, 20, 24 and 28 cm phantom. Phantom ESAK reduced by 63%, 63%, 64% and 65% for 16, 20, 24 and 28 cm, respectively, when using 0.35 mm Cu + 1 mmAl, without degrading image contrast. Three independent radiologists perceived no change in clinical image quality with added filtration. On adding 0.35 mm Cu and 1 mm Al, the KAP per examination for the HSG was reduced by 71%, while for the RUG was reduced by 75%.Key words: Additional filtration; image quality; patient dose; X-ray fluoroscopy procedure

Effect of Lowering Tube Potential and Increase Iodine Concentration of Contrast Medium on Radiation Dose and Image Quality in Computed Tomography Pulmonary Angiography Procedure: A Phantom Study

The aim of the study was to examine the effect of lowering tube potential and increase iodine concentration on image quality and radiation dose in computed tomography pulmonary angiography procedure. The pulmonary arteries were simulated by three syringes. The syringes were filled with 1:10 diluted solutions of 300 mg, 350 mg and 370 mg of iodine per millilitre concentration in three water-filled phantoms simulating thin, intermediate and thick patients. The phantoms were scanned at 80 kVp, 110 kVp and 130 kVp and 0.6 second rotation time using a 16 slice computed tomography (CT) scanner. The tube current was either fixed at 80, 100, 200, 250 and 300 mA or automatically adjusted with quality reference tube current-time product (mAsQR). In comparison with 130 kVp, images acquired at 80 kVp and 110 kVp, respectively, showed 76.2% to 99% and 19% to 26% enhancement in CT attenuation of iodinated contrast material. A volume CT dose index (CTDIvol) reduction by 35.3% was attained in small phantom with the use of 80 kVp, while in the medium phantom, a CTDIvol reduction by 29.9% was attained with the use of 110 kVp instead of 130 kVp. In light of the above, lowering tube potential and increase iodinated CM could substantially reduce the dose to small-sized adults and children