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Updated: Aug 13, 2026
X-ray Dose Reduction through Adaptive Exposure in Fluoroscopic Imaging
Published on: September 11, 2011
Radiation risk and cost-benefit analysis of a paediatric radiology procedure: results from a national study
H B L Pettersson1, K Fälth-Magnusson, J Persliden
1Department of Radiation Physics, IMV, University of Linköping, S-581 85 Linköping, Sweden.
Insights
This study assessed radiation doses from X-ray fluoroscopy-guided small intestinal biopsies for pediatric celiac disease. Findings reveal dose variations, highlighting potential for significant radiation reduction through optimized sedation and equipment.
Area of Science:
- Medical Physics
- Pediatric Gastroenterology
- Radiology
Background:
- X-ray fluoroscopy-guided small intestinal biopsies are crucial for diagnosing celiac disease in children.
- Radiation exposure is an inherent risk associated with fluoroscopic procedures.
Purpose of the Study:
- To investigate patient radiation doses during X-ray fluoroscopy-guided small intestinal biopsies in pediatric celiac disease diagnosis.
- To estimate associated cancer risks and identify methods for dose reduction.
Main Methods:
- A national study involving 42 of 43 Swedish pediatric departments.
- Use of thermoluminescent dosemeters (TLDs) and questionnaires to collect data on 257 biopsies.
- Recorded absorbed doses and fluoroscopy times over a 6-week study period.
Main Results:
- Absorbed doses ranged from 0.04 mGy to 23.8 mGy (mean 1.87 mGy).
- Fluoroscopy times varied widely, from 2s to 663s (mean 60s).
- Estimated annual excess cancer mortality is 0.6-0.7 cases per year.
Conclusions:
- Significant radiation dose variations exist in pediatric small intestinal biopsies.
- Optimizing sedation and biopsy equipment can lead to substantial radiation dose savings.
- Further research into dose optimization strategies is warranted to minimize patient risk.
Abstract:
A national study was performed to investigate radiation doses and associated risks to patients during X-ray fluoroscopy-guided small intestinal biopsies in the investigation of coeliac disease. Thermoluminescent dosemeters (TLD) and questionnaires were sent to 42 of the 43 paediatric departments in Sweden performing these biopsies. During the study period (2 x 3 weeks) 257 biopsies were recorded, representing about 10% of annually performed paediatric investigations. The results show that the absorbed dose during biopsy ranged from 0.04 mGy to 23.8 mGy (mean 1.87 mGy). The fluoroscopy time ranged from 2 s to 663 s (mean 60 s). The collective dose from the procedure amounts to 4.7 manSv year(-1). Thus, the annual excess cancer mortality, including severe hereditary effects, can be estimated at 0.6-0.7 cases per year. However, significant dose saving can be obtained by proper choice of sedation and biopsy equipment.
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