title: Optimization of a fluoroscope to reduce radiation exposure in pediatric imaging.
abstract: BACKGROUND
  A new children's hospital provided the impetus to investigate radiation dose and image quality in a fluoroscope that was specially engineered for pediatric fluoroscopy. Radiation protection management recommends radiation exposures that are as low as reasonably achievable, while still maintaining diagnostic image quality.
  
  
  OBJECTIVE
  To obtain comparative phantom imaging data on radiation exposure and image quality from a newly installed fluoroscope before and after optimization for pediatric imaging.
  
  
  METHODS
  Images were acquired from various thickness phantoms, simulating differing patient sizes. The images were evaluated for visualization of high- and low-contrast objects and for radiation exposure. Effects due to use of the image intensifier anti-scatter grid were also investigated.
  
  
  RESULTS
  The optimization of the new fluoroscope for pediatric operation reduced radiation exposure by about 50% (compared to the originally installed fluoroscope), with very little loss of image quality. Pulsed fluoroscopy was able to lower radiation dose to less than 10% of continuous fluoroscopy, while still maintaining acceptable phantom image quality.
  
  
  CONCLUSIONS
  Radiation exposure in pediatric fluoroscopy can be reduced to values well below the exposure settings that are typically found on unoptimized fluoroscopes. Pulsed fluoroscopy is considered a requisite for optimal pediatric fluoroscopy.
authors.affiliation: Department of Diagnostics Radiology, Oregon Health Sciences University, Doernbecher Children's Hospital, Portland 97201-3098, USA.
authors.forename: P H
authors.initials: PH
authors.lastname: Brown
authors.forename: R D
authors.initials: RD
authors.lastname: Thomas
authors.forename: P J
authors.initials: PJ
authors.lastname: Silberberg
authors.forename: L M
authors.initials: LM
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000367:Age Factors; D002648:Child; D005471:Fluoroscopy / Q000009:adverse effects / Q000379:methods / Q000592:standards*; D006801:Humans; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011835:Radiation Protection