Optimization of a fluoroscope to reduce radiation exposure in pediatric imaging

Background. A new children's hospital provided the impetus to investigate r adiation dose and image quality in a fluoroscope that was specially enginee red for pediatric fluoroscopy. Radiation protection management recommends r adiation exposures that are as low as reasonably achievable, while still ma intaining diagnostic image quality. Objectives. To obtain comparative phantom imaging data on radiation exposur e and image quality from a newly installed fluoroscope before and after opt imization for pediatric imaging. Materials and methods. Images were acquired from various thickness phantoms , simulating differing patient sizes. The images were evaluated for visuali zation of high- and low-contrast objects and for radiation exposure. Effect s due to use of the image intensifier anti-scatter grid were also investiga ted. Results. The optimization of the new fluoroscope for pediatric operation re duced radiation exposure by about 50% (compared to the originally installed fluoroscope), with very little loss of image quality. Pulsed fluoroscopy w as able to lower radiation dose to less than 10% of continuous fluoroscopy, while still maintaining acceptable phantom image quality. Conclusion. Radiation exposure in pediatric fluoroscopy can be reduced to v alues well below the exposure settings that are typically found on unoptimi zed fluoroscopes. Pulsed fluoroscopy is considered a requisite for optimal pediatric fluoroscopy.