title: Radiation dose for 345 CT-guided interlaminar lumbar epidural steroid injections.
abstract: OBJECTIVE
  CT guidance is increasingly being used to localize the epidural space during epidural steroid injections. A common concern is that CT may be associated with significantly higher radiation doses compared with conventional fluoroscopy. The goal of this retrospective study was to determine the average dose-length product and effective dose delivered while interlaminar epidural steroid injections are performed and allow comparison with other modalities.
  
  
  METHODS
  A total of 281 patients who had undergone 345 consecutive CT-guided epidural steroid injections of the lumbar spine were evaluated for radiation exposure. The dose-length product for each scan was derived from the CT dose index volume and scan length. Effective dose was then calculated from the dose-length product and a κ coefficient of 0.015. Procedure time was calculated from the PACS time stamp on the scout image to the last CT image of the last image series.
  
  
  RESULTS
  The average dose-length product across all procedures was 89.6 ± 3.33 mGy·cm, which represents an effective dose of 1.34 ± 0.05 mSv. No complications from the procedure were observed, and average procedure time was 8 minutes.
  
  
  CONCLUSIONS
  The use of a stationary table and an intermittent scanning technique allow for short procedures and doses that are significantly lower than those of conventional diagnostic CT scans. Furthermore, because CT dose index overestimates radiation dose in stationary table procedures, the actual radiation dose may be even lower than stated here.
authors: Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors: A L
authors: AL
authors: Chang
authors: A H
authors: AH
authors: Schoenfeld
authors: A L
authors: AL
authors: Brook
authors: T S
authors: TS
authors: Miller
mesh_terms: D003287:Contrast Media; D005260:Female; D006801:Humans; D007268:Injections, Epidural / Q000379:methods; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009485:Neuroradiography / Q000379:methods*; D009930:Organic Chemicals; D011829:Radiation Dosage; D015641:Radiography, Interventional / Q000379:methods; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D012189:Retrospective Studies; D013256:Steroids / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D009930:Organic Chemicals; D013256:Steroids; C027094:CT 345
references: Radiology. 2006 Aug;240(2):435-9
references: 16801372
references: Ann ICRP. 2007;37(2-4):1-332
references: 18082557
references: AJR Am J Roentgenol. 2009 Jun;192(6):1726-30
references: 19457841
references: Radiographics. 2008 Jan-Feb;28(1):245-53
references: 18203941
references: AJR Am J Roentgenol. 2011 Jul;197(1):W97-103
references: 21701002
references: AJNR Am J Neuroradiol. 2013 Jan;34(1):23-8
references: 22743642
references: J Vasc Interv Radiol. 2003 Sep;14(9 Pt 2):S199-202
references: 14514818
references: Cardiovasc Intervent Radiol. 2006 Jan-Feb;29(1):84-91
references: 16228853
references: Radiology. 2011 Aug;260(2):454-62
references: 21493795
references: N Engl J Med. 2007 Nov 29;357(22):2277-84
references: 18046031
references: J Spinal Disord Tech. 2008 Aug;21(6):409-12
references: 18679095
references: Radiographics. 2001 Jul-Aug;21(4):1033-45
references: 11452079
references: AJR Am J Roentgenol. 2007 Feb;188(2):433-40
references: 17242253
references: Radiology. 2011 May;259(2):311-6
references: 21502387
references: J Neurointerv Surg. 2010 Mar;2(1):6-10
references: 21990551
references: Spine (Phila Pa 1976). 1980 Jan-Feb;5(1):78-86
references: 6444766
references: AJNR Am J Neuroradiol. 2011 Nov-Dec;32(10):1776-82
references: 21920858
references: AJNR Am J Neuroradiol. 2011 Oct;32(9):E175-7
references: 21233226
references: AJR Am J Roentgenol. 2011 Oct;197(4):778-82
references: 21940563
references: Radiology. 2001 Jul;220(1):161-7
references: 11425990
references: Radiology. 2008 Sep;248(3):995-1003
references: 18710988