AI Article Synopsis
- Mini C-arm fluoroscopes are used by orthopedic surgeons for real-time imaging during surgeries, shifting the responsibility for radiation exposure to the surgeons themselves.
- Due to the absence of national diagnostic reference levels (DRLs) for mini C-arms in the UK, hospitals must establish local DRLs to ensure safe radiation practices.
- This audit analyzed 1,664 procedure doses and found that lower DAP values were associated with forearm, hand, and foot surgeries, while wrist and elbow procedures had higher values, providing valuable benchmarks for other centers to follow.
Article Abstract
Objective: Mini C-arm fluoroscopes are widely used by orthopaedic surgeons for intraoperative image guidance without the need for radiographers. This puts the responsibility for radiation exposure firmly with the operating surgeon. In order to maintain safe and best practice under U.K. Ionising Radiation (Medical Exposure) Regulations, one must limit radiation exposure and audit performance using national diagnostic reference levels (DRLs). In the case of the mini C-arm, there are no national DRLs. IR(ME)R, therefore, require the establishment of local DRLs by each hospital to act as an alternative guideline for safe radiation use. The aim of our audit was to establish local DRLs based on our experience operating with the use of the mini C-arm over the last 7 years.
Methods: This retrospective audit evaluates the end dose-area product (DAP) recorded for common trauma and orthopaedic procedures using the mini C-arm in a busy district general hospital.We present the quartile data and have set the cut-off point as the third quartile for formulating the local DRLs, consistent with the methodology for the conventional fluoroscope.
Results: For our data set ( = 1664), the third quartile DAP values were lowest for surgeries to the forearm (5.38 cGycm), hand (7.62 cGycm), and foot/ankle (8.56 cGycm), and highest for wrist (10.64 cGycm) and elbow (14.61 cGycm) procedures.
Advances In Knowledge: To our knowledge, this is the largest data set used to establish local DRLs. Other centres may find our guidelines useful whilst they establish their own local DRLs.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774701 | PMC |
| http://dx.doi.org/10.1259/bjr.20190878 | DOI Listing |
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