96 / 492
S5: IMAGING
Moderators: Kaoru Yoshino (Japan), Haluk Emir (Turkey)
ESPU Meeting on Thursday 15, October 2015, 09:24 - 10:06
09:24 - 09:27
S5-1
(PP)
★
OPTIMIZATION OF FLUOROSCOPIC IMAGING TO REDUCE RADIATION
EXPOSURE IN CHILDREN UNDERGOING ENDOUROLOGICAL INTERVENTION
Ahmed FAHMY, Hazem RHASHAD, Mohamed YOUSSIF, Ibrahim MOKHLES and Ashraf SAAD
Faculty of medicine, Alexandria University, Urology department, Alexandria, EGYPT
PURPOSE
The era of minimal-invasive surgery has created a heavy dependence on fluoroscopic guidance to allow a real time
imaging of the patient. Radiation protection management recommends radiation exposures that are as low as
reasonably achievable, while still maintaining diagnostic image quality. The aim of the study is to prospectively compare
fluroscopy time during pediatric endourological intervention before and after implementation of strategy for optimization
of fluroscopic imaging and study its effect on surgical outcomes.
MATERIAL AND METHODS
We observed 56 consecutive endourological intervention in children in whom a dose reduction strategy was adopted.
The strategy included several measures, including optimizing position by performing the procedure with the patient table
elevated while keeping the fluoroscopy table as far from the X-ray tube as possible (to reduce skin entry dose), and the
image intensifier close to the patient (to maximize image capture), use of pulsed mode with last image hold technique,
beam collimation, use of a designated fluoroscopy technician. Outcomes were compared to those in 42 children before
implementing dose reduction strategy.
Fluoroscopy times, operative time, stone free rate, perioperative complications were compared between both groups.
RESULTS
Operative time (P=0.53), stone free rate (P=0.36), and complication rate (P = 0.21) were similar between the 2 groups.
Total fluoroscopy time was significantly reduced by 55% from 1.68 to 0.75 minutes (p <0.002) with very little loss of
image quality.
CONCLUSIONS
Radiation exposure in children undergoing endourological interventions can be reduced significantly after optimization of
fluroscopy imaging. Reduced radiation protocol did not increase surgical complexity, operative time, or complication
rates while reducing radiation exposure in such susceptible population