1. High Level (Boost) 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. High Level or “Boost”
Refers to a “special activation” capability of certain fluoroscopy systems
Provides mA
In special circumstances up to 40 mA
Corresponding entrance dose rate to the patient is 2 – 10 times greater than conventional fluoroscopy
Dose rate can range from Rads per minute as measured at the table top

3. High level or Boost is used for
Interventional radiology and cardiac procedures can be very long and demanding procedures
In addition extremely small guidewires and catheters must be visualized
Requires
High signal-to-noise ratio
Very low quantum mottle
May result in total patient dose rates exceeding several hundred rads
Can cause skin erythema and possible radiation damage to underlying tissue

4. Radiation Skin Damage

5. Recent Regulations
1994, Regulations were passed that limit the maximum tabletop dose rate to 20 rads per minute when acquiring images without recording devices being utilized

6. Key points Regarding Boost
Special activation at the control panel is required with an additional person
Key and interlock must be activated
Audible signal must be heard in the room while high level or boost fluoroscopy is energized
Tabletop dose rate is limited to 20rads/min unless recording devices are used as of 1994

7. Just so you know… Department of Health and Human Services
Centers for disease and Control and Prevention
Cutaneous Radiation Injury: Fact Sheet for Physicians
Acute Radiation Syndrome: Fact Sheet for Physicians
Department of Health and Human Services
Centers for disease and Control and Prevention
Cutaneous Radiation Injury: Fact Sheet for Physicians
Acute Radiation Syndrome: Fact Sheet for Physicians

8. Next up…Lesson 4