Dr.

Syed Mubbashir jawed

 Fluoroscopy is a type of medical imaging that
shows a continuous X-ray image on a
monitor, much like an X-ray movie. During a
fluoroscopy procedure, an X-ray beam is
passed through the body. The image is
transmitted to a monitor so the movement of
a body part or of an instrument or contrast
agent (X-ray dye) through the body can be
seen in detail.
 C-arm
Under table/over table units
Conventional & Digital Units
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Conventional Fluoroscopy
Invented by Thomas Edison in 1896
Hand-held fluoroscope
Later mounted on x-ray machine
conventional fluoroscope

Image intensified fluoroscopy

First suggested by Dr. W. E. Chamberlain in
1942.
First manufactured in the early 1950s
 mA range: 0.5 5.0 mA
KVP: 70 110
depending on exam and contrast used

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The kVp of operation depends
entirely on the section of the body
that is being examined.
Fluoroscopic equipment allows the
radiologist to select an image
brightness level that is subsequently
maintained automatically by varying
the kVp, the mA, or sometimes
both. This feature of the fluoroscope
is called automatic brightness
control (ABC).
 Examination
kVp
Gallbladder
6575
Nephrostogram
7080
Myelogram
7080
Barium enema (air contrast)
8090
Upper gastrointestinal
100110
Small bowel
110120
Barium enema
110120
 The image-intensifier tube is a complex electronic
device that receives the image-forming x-ray beam
and converts it into a visible-light image of high
intensity. The tube components are contained
within a glass or metal envelope that provides
structural support but more importantly maintains
a vacuum. When installed, the tube is mounted
inside a metal container to protect it from rough
handling and breakage.
Advantages
Brighter image
Lower radiation dose
0.5 3 mA
Use of more/better image
recording devices

The principal advantage of image-intensified fluoroscopy over

earlier types of fluoroscopy is increased image brightness. Just
as it is much more difficult to read a book in dim illumination
than in bright illumination, it is much harder to interpret a dim
fluoroscopic image than a bright one

Disadvantages
Expensive!

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 The conventional cassette-loaded spot film
The photospot camera is similar to a movie camera
except that it exposes only one frame when
activated
Important to keep the curtain in place

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 Lead apron
0.25 mm Pb/eq
Highest energy scatter
Same level as radiographer /radiologists gonads
(135o under table)
OR for eyes (over table 45o)

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Always make sure the foot
Board is correctly in place
BEFORE standing a pt on the table
Check weight limit for table

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Depending on the study the patient may begin in the upright position
The Radiologist may then place the patient and table recumbant to finish the fluoro
study

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 Fluoroscopy is used in many types of
examinations and procedures. Some
examples include the following:

Orthopedic procedures, such as manipulation

of broken bones in fracture reduction or
insertion of implants and checking
appropriate positioning or alignment

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 Gastrointestinal investigations using contrast
agents, such as barium in the intestine to
study its outline and movement

Cardiovascular and interventional radiology

procedures, such as catheter insertion and
monitoring of its progress (e.g., to undo a
blockage or insert a stent)

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 Fluoroscopy involves the use of ionizing
radiation and, therefore, is relatively
contraindicated in pregnant women due to
potential harmful effects on a developing
fetus. As in any clinical intervention, the
potential risks must outweigh the intended
benefits.

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Fluoroscopy is used in a wide variety of examinations
and procedures to diagnose or treat patients. Some
examples are:

Barium X-rays and enemas (to view the

gastrointestinal tract)
Catheter insertion and manipulation (to direct the
movement of a catheter through blood vessels, bile
ducts or the urinary system)
Placement of devices within the body, such as stents
(to open narrowed or blocked blood vessels)
Angiograms (to visualize blood vessels and organs)
Orthopedic surgery (to guide joint replacements and
treatment of fractures)
 Fluoroscopy carries some risks, as do other X-ray
procedures. The radiation dose the patient receives
varies depending on the individual procedure.
Fluoroscopy can result in relatively high radiation
doses, especially for complex interventional
procedures (such as placing stents or other devices
inside the body) which require fluoroscopy be
administered for a long period of time. Radiation-
related risks associated with fluoroscopy include:
radiation-induced injuries to the skin and underlying
tissues (burns), which occur shortly after the
exposure, and
radiation-induced cancers, which may occur some
time later in life.