Flat detectors and new aspects of radiation safety

Flat detectors are the heart of high-performance imaging systems that provide new capabilities as well as new hazards. The superior image quality enables operators to work with heavier patients and steeper projections. Under these conditions, exposure control computers automatically increase the production of x-rays to compensate for absorption by body tissues. Image quality is preserved, and operators may not be aware of the very high skin doses delivered during prolonged procedures. Although it is assumed that flat detector systems are safe, the potential for radiation overexposure and skin injury is real. This article examines the unique radiation hazards of flat detector fluoroscopy and suggests practical steps that clinicians can take to protect themselves and their patients from radiation injury.