Skip to main content

Advertisement

SpringerLink
Log in

Linear relationship between absorbed radiation dose and pulse rate during fluoroscopy

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

To identify the relationship between fluoroscopy pulse rate and absorbed radiation dose. We compared absorbed radiation dose with common proxy measurements such as fluoroscopy time and C-arm reported dose.

Methods

Using a simulated patient model, 60 s fluoroscopy exposures were performed using pulse rates of 30, 8, 4, 2, and 1 pulse(s) per second. Each experiment was performed with both standard and low-dose settings using a GE OEC 9800 plus C-arm. Landauer nanoDot™ OSL dosimeters were used to measure the absorbed radiation dose.

Results

Fluoroscopy pulse rate and absorbed radiation dose demonstrated a linear correlation for both standard (R2 = 0.995, p < 0.001) and low-dose (R2 = 0.998, p < 0.001) settings. For any given pulse rate, using the low-dose setting reduced absorbed radiation dose by 58 ± 2.8%. Fluoroscopy time demonstrated a linear relationship with absorbed radiation dose for both standard (R2 = 0.996, p < 0.001) and low-dose (R2 = 0.991, p < 0.001) settings, but did not change with use of the low-dose setting. C-arm reported radiation dose correlated linearly with absorbed dose (R2 = 0.999) but consistently under-estimated measured values by an average of 49 ± 3.5%. Using a combination of 1 pulse-per-second and low-dose fluoroscopy, absorbed dose was reduced by 97.7 ± 0.1% compared to standard dose and 30 pulse-per-second settings.

Conclusion

Absorbed radiation dose decreases linearly with fluoroscopy pulse rate during equivalent exposure times. Adjusting fluoroscopy pulse rate and utilizing low-dose settings significantly reduces overall absorbed radiation exposure by up to 98%.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data availability

The data underlying this study are available from the corresponding author upon reasonable request.

References

  1. Canales BK, Sinclair L, Kang D, Mench AM, Arreola M, Bird VG (2016) Changing default fluoroscopy equipment settings decreases entrance skin dose in patients. J Urol 195(4, Part 1):992–997

    Article  Google Scholar 

  2. Elkoushy MA, Shahrour W, Andonian S (2012) Pulsed fluoroscopy in ureteroscopy and percutaneous nephrolithotomy. Urology 79(6):1230–1235

    Article  Google Scholar 

  3. Yecies TS, Fombona A, Semins MJ (2017) Single pulse-per-second setting reduces fluoroscopy time during ureteroscopy. Urology 103:63–67

    Article  Google Scholar 

  4. Smith DL, Heldt JP, Richards GD, Agarwal G, Brisbane WG, Chen CJ et al (2013) Radiation exposure during continuous and pulsed fluoroscopy. J Endourol 27(3):384–388

    Article  Google Scholar 

  5. Mahesh M (2001) Fluoroscopy: patient radiation exposure issues. Radiographics 21(4):1033–1045

    Article  CAS  Google Scholar 

  6. Council NR(2006) Health risks from exposure to low levels of ionizing radiation: BEIR VII phase 2

  7. Ferrandino MN, Bagrodia A, Pierre SA, Scales CD, Rampersaud E, Pearle MS et al (2009) Radiation exposure in the acute and short-term management of urolithiasis at 2 academic centers. J Urol 181(2):668–673

    Article  Google Scholar 

  8. Dudley AG, Semins MJ (2015) Radiation practice patterns and exposure in the high-volume endourologist. Urology 85(5):1019–1024

    Article  Google Scholar 

  9. Kotre CJ, Charlton S, Robson KJ, Birch IP, Willis SP, Thornley M (2004) Application of low dose rate pulsed fluoroscopy in cardiac pacing and electrophysiology: patient dose and image quality implications. Br J Radiol 77(919):597–599

    Article  CAS  Google Scholar 

  10. Sabat S, Slonimsky E (2018) Radiation reduction in low dose pulsed fluoroscopy versus standard dose continuous fluoroscopy during fluoroscopically-guided lumbar punctures: a prospective controlled study. J Clin Imaging Sci. 8:9

    Article  Google Scholar 

  11. Durutovic O, Dzamic Z, Milojevic B, Nikic P, Mimic A, Bumbasirevic U et al (2016) Pulsed versus continuous mode fluoroscopy during PCNL: safety and effectiveness comparison in a case series study. Urolithiasis 44(6):565–570

    Article  Google Scholar 

  12. Boland GWL, Murphy B, Arellano R, Niklason L, Mueller PR (2000) Dose reduction in gastrointestinal and genitourinary fluoroscopy. Am J Roentgenol 175(5):1453–1457

    Article  CAS  Google Scholar 

  13. Ward VL, Barnewolt CE, Strauss KJ, Lebowitz RL, Venkatakrishnan V, Stehr M et al (2006) Radiation exposure reduction during voiding cystourethrography in a pediatric porcine model of vesicoureteral reflux. Radiology 238(1):96–106

    Article  Google Scholar 

Download references

Funding

The authors did not receive support from any organization for the submitted work.

Author information

Author notes

  1. Todd S. Yecies and Brian Chun are co-first authors.

Authors and Affiliations

  1. Department of Urology, Palo Alto Foundation Medical Group, Palo Alto, CA, USA

    Todd S. Yecies

  2. Department of Urology, UPMC Children’s Hospital of Pittsburgh, 3471 Fifth Avenue. Suite 700, Pittsburgh, PA, 15213, USA

    Brian Chun & Rajeev Chaudhry

  3. Department of Urology, West Virginia University School of Medicine, Morgantown, WV, USA

    Michelle J. Semins

Authors
  1. Todd S. Yecies
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Brian Chun
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michelle J. Semins
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rajeev Chaudhry
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

TSY: project development, data collection, data analysis, manuscript writing. BC: project development, data management, data analysis, manuscript writing, manuscript editing. MJS: project development, data analysis, manuscript editing. RC: project development, manuscript editing.

Corresponding author

Correspondence to Brian Chun.

Ethics declarations

Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical standards

Our study did not utilize human participants or patient information and was exempted by the International Review Board at the University of Pittsburgh.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yecies, T.S., Chun, B., Semins, M.J. et al. Linear relationship between absorbed radiation dose and pulse rate during fluoroscopy. World J Urol 41, 269–274 (2023). https://doi.org/10.1007/s00345-022-04238-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-022-04238-2

Keywords

Search

Navigation