CardioVascular and Interventional Radiology

, Volume 29, Issue 1, pp 84–91

Effective Dose of CT- and Fluoroscopy-Guided Perineural/Epidural Injections of the Lumbar Spine: A Comparative Study

  • Gebhard Schmid
  • Alexander Schmitz
  • Dieter Borchardt
  • Klaus Ewen
  • Thomas von Rothenburg
  • Odo Koester
  • Michael Jergas
CLINICAL INVESTIGATION

DOI: 10.1007/s00270-004-0355-3

Cite this article as:
Schmid, G., Schmitz, A., Borchardt, D. et al. Cardiovasc Intervent Radiol (2006) 29: 84. doi:10.1007/s00270-004-0355-3

Abstract

The objective of this study was to compare the effective radiation dose of perineural and epidural injections of the lumbar spine under computed tomography (CT) or fluoroscopic guidance with respect to dose-reduced protocols. We assessed the radiation dose with an Alderson Rando phantom at the lumbar segment L4/5 using 29 thermoluminescence dosimeters. Based on our clinical experience, 4–10 CT scans and 1-min fluoroscopy are appropriate. Effective doses were calculated for CT for a routine lumbar spine protocol and for maximum dose reduction; as well as for fluoroscopy in a continuous and a pulsed mode (3–15 pulses/s). Effective doses under CT guidance were 1.51 mSv for 4 scans and 3.53 mSv for 10 scans using a standard protocol and 0.22 mSv and 0.43 mSv for the low-dose protocol. In continuous mode, the effective doses ranged from 0.43 to 1.25 mSv for 1–3 min of fluoroscopy. Using 1 min of pulsed fluoroscopy, the effective dose was less than 0.1 mSv for 3 pulses/s. A consequent low-dose CT protocol reduces the effective dose compared to a standard lumbar spine protocol by more than 85%. The latter dose might be expected when applying about 1 min of continuous fluoroscopy for guidance. A pulsed mode further reduces the effective dose of fluoroscopy by 80–90%.

Keywords

Computed tomography (CT), guidanceComputed tomography (CT), radiation exposureFluoroscopyPhantomsSpine, lumbarInterventionThermoluminescence dosimeter

Copyright information

© Springer Science+Business Media, Inc. 2005

Authors and Affiliations

  • Gebhard Schmid
    • 1
    • 2
  • Alexander Schmitz
    • 2
  • Dieter Borchardt
    • 3
  • Klaus Ewen
    • 4
  • Thomas von Rothenburg
    • 2
  • Odo Koester
    • 2
  • Michael Jergas
    • 2
  1. 1.Department of Radiology and Nuclear MedicineJohanna-Etienne-KrankenhausGermany
  2. 2.Department of Radiology and Nuclear MedicineSt.-Josef-Hospital–Ruhr-UniversityGermany
  3. 3.Department of Radiation OncologySt.-Josef-Hospital–Ruhr-UniversityGermany
  4. 4.State Institute for Occupational Safety and Health of North Rhine–WestphaliaGermany