Fluoroscopy

Dr. Syed Mubbashir jawed

 Fluoroscopy is a type of medical imaging
that shows a continuous X-ray image on a
monitor, much like an X-ray movie. During a
fluoroscopy procedure, an X-ray beam is
passed through the body. The image is
transmitted to a monitor so the movement
of a body part or of an instrument or
contrast agent (X-ray dye) through the
body can be seen in detail.
TYPES OF EQUIPMENT
C-arm
Under table/over table
units
Conventional & Digital
Units
TUBE ABOVE THE TABLE:
TUBE UNDER THE TABLE:
Over vs Under the table
fluoro tubes & Scatter

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C-ARM FLUOROSCOPY:
History :
Conventional Fluoroscopy
Invented by Thomas Edison in 1896
Hand-held fluoroscope
Later mounted on x-ray machine
conventional fluoroscope

Image intensified fluoroscopy

First suggested by Dr. W. E. Chamberlain in

1942.
First manufactured in the early 1950s
Equipment:
Fluoroscopic X-Ray Tubes
mA range: 0.5 5.0 mA
KVP: 70 110
depending on exam and contrast used

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The kVp of operation depends
entirely on the section of the body
that is being examined.
Fluoroscopic equipment allows the
radiologist to select an image
brightness level that is
subsequently maintained
automatically by varying the kVp,
the mA, or sometimes both. This
feature of the fluoroscope is called
automatic brightness control
(ABC).
kVp DEPENDS ON THE BODY
PART BEING EXAMINED
Examination
kVp
Gallbladder
6575
Nephrostogram
7080
Myelogram
7080
Barium enema (air contrast)
8090
Upper gastrointestinal
100110
Small bowel
110120
Barium enema
110120
Image intensifier:
The image-intensifier tube is a complex electronic
device that receives the image-forming x-ray
beam and converts it into a visible-light image of
high intensity. The tube components are
contained within a glass or metal envelope that
provides structural support but more importantly
maintains a vacuum. When installed, the tube is
mounted inside a metal container to protect it
from rough handling and breakage.
Image Intensification

Advantages
Brighter image

Lower radiation dose

0.5 3 mA

Use of more/better image

recording devices

The principal advantage of image-intensified fluoroscopy over

earlier types of fluoroscopy is increased image brightness. Just as it
is much more difficult to read a book in dim illumination than in
bright illumination, it is much harder to interpret a dim fluoroscopic
image than a bright one

Disadvantages
Expensive!

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Image Recording:
The conventional cassette-loaded spot film
The photospot camera is similar to a movie
camera except that it exposes only one frame
when activated
Important to keep the curtain in place

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Protection of Radiographer
and Radiologist
Lead apron
0.25 mm Pb/eq
Highest energy scatter
Same level as radiographer /radiologists gonads
(135o under table)
OR for eyes (over table 45o)

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Always make sure the foot
Board is correctly in place
BEFORE standing a pt on the table
Check weight limit for table

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Depending on the study the patient may begin in the upright position
The Radiologist may then place the patient and table recumbant to finish the
fluoro study

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INDICATIONS
Fluoroscopy is used in many types of
examinations and procedures. Some
examples include the following:

Orthopedic procedures, such as

manipulation of broken bones in fracture
reduction or insertion of implants and
checking appropriate positioning or
alignment

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 Gastrointestinal investigations using
contrast agents, such as barium in the
intestine to study its outline and movement

Cardiovascular and interventional radiology

procedures, such as catheter insertion and
monitoring of its progress (e.g., to undo a
blockage or insert a stent)

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 CONTRAINDICATIONS

Fluoroscopy involves the use of ionizing

radiation and, therefore, is relatively
contraindicated in pregnant women due to
potential harmful effects on a developing
fetus. As in any clinical intervention, the
potential risks must outweigh the intended
benefits.

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Benefits:
Fluoroscopy is used in a wide variety of examinations and
procedures to diagnose or treat patients. Some examples are:

Barium X-rays and enemas (to view the gastrointestinal tract)

Catheter insertion and manipulation (to direct the movement
of a catheter through blood vessels, bile ducts or the urinary
system)
Placement of devices within the body, such as stents (to open
narrowed or blocked blood vessels)
Angiograms (to visualize blood vessels and organs)
Orthopedic surgery (to guide joint replacements and
treatment of fractures)
Risks:
Fluoroscopy carries some risks, as do other X-ray
procedures. The radiation dose the patient receives varies
depending on the individual procedure. Fluoroscopy can
result in relatively high radiation doses, especially for
complex interventional procedures (such as placing stents
or other devices inside the body) which require fluoroscopy
be administered for a long period of time. Radiation-related
risks associated with fluoroscopy include:
radiation-induced injuries to the skin and underlying tissues

(burns), which occur shortly after the exposure, and

radiation-induced cancers, which may occur some time

later in life.