title: Fluoroscopy-guided placement of nasoenteral tubes in children using intermittent digital pulse fluoroscopy and last image save/grab technique.
abstract: OBJECTIVE
  To document the radiation exposure metrics, including fluoroscopic radiation time and radiation dose-area product, in children <18 years of age who undergo nasoenteral tube placement using fluoroscopic guidance with maximal dose-reduction techniques.
  
  
  METHODS
  Following institutional review board approval, the age, gender, anatomical information, immediate procedure-related complications if any, fluoroscopy time, and radiation dose-area product were collected retrospectively in all paediatric patients who underwent fluoroscopically guided nasoenteral tube placement during a 5-year period. Three paediatric radiology faculty members, a radiologist assistant, and trainee residents during their paediatric radiology rotation performed the procedures on two different digital fluoroscopic machines using radiation-minimising techniques. Median values of the fluoroscopy time and radiation dose-area product were calculated and compared to values reported in the literature using the Wilcoxon procedure.
  
  
  RESULTS
  There were 41 male and 33 female patients with a median age of 4 years and 6 months. Median fluoroscopy time used for placing a nasoenteral tube was 1.25 minutes with a median radiation exposure dose-area product of 0.245 Gy·cm(2). All patients had successful placement of nasoenteral tube without immediate procedure-related complications.
  
  
  CONCLUSIONS
  Fluoroscopy-guided nasoenteral feeding tube placement can be performed successfully with minimal radiation exposure without compromising procedural success.
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas St, MSC 323, Charleston, SC 29425-3230, USA. Electronic address: raoa@musc.edu.
authors.forename: A G
authors.initials: AG
authors.lastname: Rao
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas St, MSC 323, Charleston, SC 29425-3230, USA.
authors.forename: C E
authors.initials: CE
authors.lastname: Simmons
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas St, MSC 323, Charleston, SC 29425-3230, USA.
authors.forename: H
authors.initials: H
authors.lastname: Collins
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas St, MSC 323, Charleston, SC 29425-3230, USA.
authors.forename: S V
authors.initials: SV
authors.lastname: Tipnis
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas St, MSC 323, Charleston, SC 29425-3230, USA.
authors.forename: J G
authors.initials: JG
authors.lastname: Hill
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas St, MSC 323, Charleston, SC 29425-3230, USA.
authors.forename: E R
authors.initials: ER
authors.lastname: Ritenour
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition / Q000295:instrumentation / Q000379:methods; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007441:Intubation, Gastrointestinal / Q000295:instrumentation / Q000379:methods*; D008297:Male; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000032:analysis* / Q000517:prevention & control*; D011835:Radiation Protection / Q000379:methods*; D011856:Radiographic Image Enhancement / Q000379:methods; D015641:Radiography, Interventional / Q000379:methods*; D011874:Radiometry; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique