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Updated: May 28, 2026

X-ray Dose Reduction through Adaptive Exposure in Fluoroscopic Imaging

X-ray Dose Reduction through Adaptive Exposure in Fluoroscopic Imaging

Published on: September 11, 2011

Radiation exposure during endourologic procedures using over-the-table fluoroscopy sources.

Manuel Ritter¹, Patrick Krombach, Andreas Martinschek

¹Department of Urology, University Medical Center Mannheim, Mannheim, Germany. manuel.ritter@umm.de

Journal of Endourology

|October 19, 2011

Summary

Endourologic surgeons

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Area of Science:

Urology
Medical Physics
Radiology

Background:

Fluoroscopy is integral to endourologic surgery.
Surgeons often lack awareness of their radiation exposure.
Assessing radiation doses is crucial for safety.

Purpose of the Study:

To quantify radiation exposure for endourologic surgeons.
To evaluate doses during common endourologic interventions.
To inform radiation safety practices in urology.

Main Methods:

Prospective study of 235 endourologic interventions.
Radiation dose measured using thermoluminescent dosimeters (TLDs) on surgeons.
Forehead and finger TLDs monitored radiation to eyes, thyroid, and hands.
Interventions included ureteral stent placement/change, percutaneous stent change, PCNL, and URS.

Main Results:

Forehead radiation doses varied by procedure, with PCNL highest (0.18 mSv).
Finger radiation doses were higher, particularly for PCNL (4.36 mSv).
Most procedures resulted in doses below statutory limits.

Conclusions:

Endourologic surgeons receive measurable radiation doses during procedures.
Percutaneous nephrolithotomy (PCNL) poses the highest radiation risk.
Surgeons should implement protective measures, especially during PCNL.