title: Hysterosalpingography using a flat panel unit: evaluation and optimization of ovarian radiation dose.
abstract: OBJECTIVE
  The aim of the present study was the evaluation and optimization of radiation dose to the ovaries (D) in hysterosalpingography (HSG).
  
  
  METHODS
  The study included a phantom study and a clinical one. In the phantom study, we evaluated imaging results for different geometrical setups and irradiation conditions. In the clinical study, 34 women were assigned into three different fluoroscopy modes and D was estimated with direct cervical TLD measurements.
  
  
  RESULTS
  In the phantom study, we used a source-to-image-distance (SID) of 110 cm and a field diagonal of 48 cm, and thus decreased air KERMA rate (KR) by 19% and 70%, respectively, for beam filtration: 4 mm Al and 0.9 mm Cu (Low dose). The least radiation exposure was accomplished by using the 3.75 pps fluoroscopy mode in conjunction with beam filtration: Low dose. In the clinical study, D normalized to 50 s of fluoroscopy time with a 3.75 pps fluoroscopy mode reached a value of 0.45 ± 0.04 mGy. Observers' evaluation of diagnostic image quality did not significantly differ for the three different modes of acquisition that were compared.
  
  
  CONCLUSIONS
  Digital spot radiographs could be omitted in modern flat panel systems during HSG. Fluoroscopy image acquisitions in a modern flat panel unit at 3.75 pps and a beam filtration of 4 mm Al and 0.9 mm Cu demonstrate acceptable image quality with an average D equal to 0.45 mGy. This value is lower compared to the studied literature. For these reasons, the proposed method may be recommended for routine HSG examination in order to limit radiation exposure to the ovaries.
authors: Department of Medical Physics, University Hospital of Patras, Rion, Greece.
authors: Gerasimos A T
authors: GA
authors: Messaris
authors: Ilias
authors: I
authors: Abatzis
authors: George C
authors: GC
authors: Kagadis
authors: Alexandros P
authors: AP
authors: Samartzis
authors: Panagiota
authors: P
authors: Athanasopoulou
authors: Nikolaos
authors: N
authors: Christeas
authors: Konstantinos
authors: K
authors: Katsanos
authors: Dimitrios
authors: D
authors: Karnabatidis
authors: George C
authors: GC
authors: Nikiforidis
mesh_terms: D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000295:instrumentation* / Q000379:methods; D010053:Ovary / Q000000981:diagnostic imaging* / Q000528:radiation effects; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods*; D011874:Radiometry / Q000379:methods*; D014963:X-Ray Intensifying Screens