Fluoroscopic optimal conditions

[Taylor_1989]

Homework Statement

You have been asked to provide a strategy for achieving radiation dose reduction for a radiology procedure in the X-ray Department. The procedure involves the slow insertion and careful positioning of a small metal catheter into the artery of a patient using fluoroscope. The procedure is challenging and normally takes several minutes to achieve. It is imperative that the measures you advise to achieve dose reduction are not likely to threaten the quality (and hence successful outcome) of the procedure.

The fluoroscope system itself is a pulsed design, i.e. it provides a real-time image by generating a running sequence of low dose frames. The frame rate, the kilo voltage selected for X-ray spectrum, and the dose used per frame for the fluoroscope are all variable.

Which of the following should, in principle, be the best strategy to explore? Please select one answer only
Select one:
a.
Maintain the frame rate, increase the kilovoltage and maintain the dose per frame
b.
Decrease the frame rate, increase the kilovoltage and maintain the dose per frame.
c.
Decrease the frame rate, decrease the kilovoltage and maintain the dose per frame
d.
Maintain the frame rate, decrease the kilovoltage and decrease the dose per frame.
e.
Decrease the frame rate, increase the kilovoltage and decrease the dose per frame

Homework Equations

The Attempt at a Solution

So I am having an issue with this question. I have highlighted in bold to what I think I relevant here my thoughts, I am torn between choosing b) and c) the reason are as follows.

As the procedure is a slow process my frame rate could be decrease as this would not effect the image quality but it would reduce the exposure to the patient. I also think that maintain the dose rate is the best option as these are already low dose frames, then if the dose per frame was decrease further the image quality would be reduced, my issue is the KV, I know that metal has a high contrast so will show up pretty much anywhere, but I don't know what type of contrast the artery has, but on the other hand if a high voltage will give a lower dose to the patient, i mean there will be more image noise but this is a random and I can't see in my mind the noise effecting the image quality that much.

On the other hand low KV will result in more dose to the patient overall time, but it produces a higher contrast which would I presume show up the artery more and prove a more successful outcome and you would have a low noise.

I mean if both procedure were over the same time frame then b) as it has the lowest dose rate for the patient and provding the artery can be seen.

But as a time frame has not been given, then my option I would choose would be c) reason is that though a higher dose over a time frame the artery will be seen more clearly and more successful out come will be had plus if the artery is seen more easily then I suppose the could decrease the overall time.

 

[Gene Naden]

if a high voltage will give a lower dose to the patient

I would expect that raising the voltage would not decrease the dose.

On the other hand low KV will result in more dose to the patient overall time

Why do you feel that lowering the voltage will result in more dose?

 

[Taylor_1989]

I would expect that raising the voltage would not decrease the dose.

I nly say this is beacuse with more power given the there x-ray would be able to pass thought the patient body and which would cause for less sctatter so reducing the dose.

Why do you feel that lowering the voltage will result in more dose?

This is the reason to why I think it would increase the dosage on the patient as the x-ray would not be as effective in pnertraing the pateinet and more scatter would occur

 

[Gene Naden]

With more power the dose is the same or increased.

 

[Taylor_1989]

With more power the dose is the same or increased.

I am now thinking it not actually going to increase the dose, it if a pulse system I think.