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Updated: Feb 27, 2026
X-ray Dose Reduction through Adaptive Exposure in Fluoroscopic Imaging
Published on: September 11, 2011
A pilot study investigating two dose reduction techniques for AP lumbar spine radiography using direct dosimetry and
1School of Clinical Sciences, Faculty of Health, University of Canberra, Australia; School of Health and Biomedical Sciences, RMIT University, Australia.
Introduction:
The purpose of this study was to compare radiation dose measurements generated using a virtual radiography simulation with experimental dosimeter measurements for two radiation dose reduction techniques in digital radiography.
Methods:
Entrance Surface Dose (ESD) measurements were generated for an antero-posterior lumbar spine radiograph experimentally using NanoDOT™, single point dosimeters, for two radiographic systems (systems 1 and 2) and using Projection VR™, a virtual radiography simulation (system 3). Two dose reduction methods were tested, application of the 15% kVp rule, or simplified 10 kVp rule, and the exposure maintenance formula. The 15% or 10 kVp rules use a specified increase in kVp and halving of the mAs to reduce patient ESD. The exposure maintenance formula uses the increase in source-to-object distance to reduce ESD.
Results:
Increasing kVp from 75 to 96 kVp, with the concomitant decrease in mAs, resulted in percent ESD reduction of 59.5% (4.02-1.63 mGy), 60.8% (3.55-1.39 mGy), and 60.3% (6.65-2.64 mGy), for experimental systems 1 and 2, and virtual simulation (system 3), respectively. Increasing the SID (with the appropriate increase in mAs) from 100 to 140 cm reduced ESD by 22.3% 18.8%, and 23.5%, for experimental systems 1 and 2, and virtual simulation (system 3), respectively.
Conclusion:
Percent dose reduction measurements were similar between the experimental and virtual measurement systems investigated. For the dose reduction practices tested, Projection VR™ provides a realistic alternate of percent dose reduction to direct dosimetry.
