Related Experiment Video
Updated: May 22, 2026
09:00
Laminotomy for Lumbar Dorsal Root Ganglion Access and Injection in Swine
Published on: October 10, 2017
CT-guided lumbar nerve root injections: are we using the correct radiation dose settings?
J S Schauberger1, P G Kranz, K R Choudhury
1Departments of Radiology, Duke University Medical Center, Durham, North Carolina 27710, USA.
AJNR. American Journal of Neuroradiology
|May 12, 2012
Summary
Proceduralist preference significantly impacts radiation dose in CT-guided spine injections. Patient body size, not preference, is key for optimizing tube current and maintaining image quality for reduced radiation exposure.
Area of Science:
- Radiology
- Medical Imaging
- Interventional Procedures
Background:
- Radiation dose reduction is crucial in CT fluoroscopy.
- Lowering tube current is a primary method for dose reduction.
- Proceduralist preference, not patient factors, often dictates tube current settings.
Purpose of the Study:
- Compare tube current and fluoroscopy time across different proceduralists for CT-guided selective nerve root blocks (SNRBs).
- Correlate image quality with patient diameter and selected tube current.
- Identify objective parameters for optimizing radiation dose during spine injections.
Main Methods:
- Retrospective review of 80 CT-guided SNRBs.
- Analysis of tube current and fluoroscopy time per proceduralist.
- Objective and subjective image quality assessment, including noise measurement and grading.
- Measurement of patient anteroposterior (AP) diameter from scout images.
Main Results:
- Significant variability observed in mean tube current (nearly 2-fold) and fluoroscopy time (over 2-fold) between proceduralists (P < .0001 and P < .01).
- Patient AP diameter was the only statistically significant factor influencing image noise (P = .009).
- Adequate to excellent image quality was achieved in 20/23 patients with AP diameter ≤30 cm, even at tube currents ≤40 mA.
Conclusions:
- Wide variability in proceduralist choices for tube current necessitates objective selection methods.
- Patient body size (AP diameter) is the most influential factor on image quality.
- Utilizing AP diameter can guide selection of lower tube currents, optimizing radiation dose without compromising image quality.
