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Thursday, March 1, 2001

Inverted position reduces patient radiation exposure

A comparison of the radiation exposure with two possible positions of the C-arm found that the inverted position in which the image intensifier is used as a table and the X-ray tube is up significantly reduces radiation exposure to the surgeon and patient in upper extremity surgery.

In a study, presented Wednesday in scientific paper 8, a C-arm was used to radiate a phantom hand in several configurations. In the first, the phantom hand was placed on an arm board equidistant from the X-ray tube and image intensifier with the beam directed upwards. The second consisted of the C-arm in an inverted position with the beam directed downward and the image intensifier used as a table. The third configuration was identical to the second except that a magnified image was used.

Radiation exposure was measured at four locations. These corresponded to the approximate position of the surgeon's head, body and groin, and to the patient's hand. There was a significant decrease in the radiation exposure to both the surgeon and patient when using the C-arm in the inverted position (p < 0.0001). The dose to the patient's extremity was reduced by 59 percent. The radiation exposure to the surgeon's head, body and groin with the inverted C-arm technique were 67 percent, 45 percent and 15 percent of the measured doses in the standard configuration.

When the inverted C-arm technique was performed using the magnification mode the doses to the surgeon's head, body and groin were further reduced to 46 percent, 32 percent and 10 percent of the standard configuration values.

Coauthors of the study are Michael R. Tremains, MD; Gregory M. Georgiadis, MD; and Michael J. Dennis, PhD, all of the Medical College of Ohio, Toledo, Ohio

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Last modified 14/February/2001 by IS