1. Pediatric Fluoroscopy
Based on:
Syllabus on Fluoroscopy Radiation Protection, 6th Rev.
By: Radiologic Health Branch – Certification Unit
PPT created by: Jed Miles, BSRS, RT(R), CRT-CA

2. Introduction
Fluoroscopy should only be performed on children if radiography cannot provide the necessary information
Significant issues to keep in mind when performing fluoroscopy on children:
Motion
Personnel and parental protection
Gonad shielding
Artifacts
Automatic Brightness Control (ABC)
Distance
Other special technical considerations

3. Motion Motion accounts for more imaging problems than for adults
Methods to consider prior to exposure are:
Establish a friendly, non-threatening rapport with the child to obtain trust and cooperation
Practice breath-holding or position changing
Anesthesia or sedation for long procedures
Minimal mechanical immobilization

4. Personnel and Parental Protection
In situations when hospital personnel or parents must physically restrain a child:
Remember that scatter radiation from the fluoroscopic examination can be significant for those standing near the patient
Leaded gloves and aprons should be worn by whoever is holding the patient and all other personnel standing near the patient

5. Gonadal Shielding
Genetic effects of radiation thought to be cumulative
Children may experience deleterious effects in their offspring years later
Gonadal shielding of at least 0.5 mm lead equivalent must be used whenever possible

6. Artifacts Exposure settings for young children generally lower
Artifacts from clothing can easily degrade image quality
Remove all clothing, bandages, and diapers from area of interest prior to conducting fluoroscopic examination

7. Automatic Brightness Control (ABC)
Particularly valuable for fluoroscopy examinations on children
Due to more variation in children’s body sizes
Will not function properly unless child covers entire exposure detection device
Exception when very radiopaque structures are in exposure field (metal structures and barium-filled stomach)
ABC controls will sense dim image and increase exposure factors to maximum
Avoid having contrast-filled structures in center or large portion of screen
When this happens adjust technical factors manually
Higher kVp =better tissue penetration and less absorbed dose

8. Distance
Shortest possible patient-to-image intensifier distance should be used
Longer distances = increased scattered radiation dose to patient and operator
Increasing distance increases motion and penumbral blur

9. Other Technical Considerations
Utilize smallest possible beam size
Keep cineradiography frame rates to minimum necessary for examination to reduce cumulative absorbed dose
Grids (which increase patient dose) may not be necessary when exposing small infants
Use photospot film and digital photospot cameras whenever possible for children to significantly reduce radiation dose
Spot film cameras allow for much shorter exposure times which decreases potential motion blurring

10. What’s Next?
Please close this PowerPoint presentation, and then click Topic 3 to continue.