초록접수[미리보기]

21KF-015
Comparison of radiation exposure to physicians between anteroposterior and lateral real-time fluoroscopy

Minjin LEE1, Won-joongKIM1, Rack Kyung CHUNG1, Hee Jung BAIK1, DongYeon KIM1, Jong In HAN1, Heeseung LEE1 JongWha LEE1, Sooyoung CHO1, Youn Jin KIM2, JaeHee WOO2

1 Department of Anesthesiology and Pain Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea

2 Department of Anesthesiology and Pain Medicine, Ewha Womans University Seoul Hospital, Seoul, Korea


Introduction
Lumbar transforaminal epidural steroid injections (L-TFESIs) are used widely to alleviate low back radicular pain but it requires real-time fluoroscopy, which can increase the risk of radiation exposure. Anteroposterior (AP) or lateral real-time fluoroscopy can be used during L-TFESIs, but there have been no comparative studies on the exposure of physicians to radiation from AP or lateral real-time fluoroscopy. The aim of this study was to compare the cumulative radiation exposure to each body part of the physician depending on the methods of real-time fluoroscopy when performing L-TFESIs.

Methods
A single physician performed L-TFESIs, and 2 groups of patients were formed based on the method used: group A (AP real-time fluoroscopy) and group L (lateral real-time fluoroscopy). Dosimetry badges were placed 1) outside the chest, 2) inside the chest, 3) outside the thyroid collar, 4) inside the thyroid collar, 5) outside the groin, 6) inside the groin, 7) ring finger (outside of lead gloves), and 8) left rim of the glasses.

Results
A total of 200 L-TFESIs were analyzed and the radiation exposure was measured by cumulative dose equivalents (DEs) in mSv. The DEs were lower at every level in group A compared with group L except for outside the groin; the DEs of group A were 97% outside the chest, 25% inside the chest, 60% outside the thyroid, 13% inside the thyroid, 81% at the fingers, and 91% at the eyes. The DE outside the groin in group L was 87% compared with group A.

Conclusions
The cumulative radiation exposure at all the measurement sites was lower for AP real-time fluoroscopy compared with lateral real-time fluoroscopy when performing L-TFESIs, except for outside the groin.