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Updated: Sep 6, 2025

X-ray Dose Reduction through Adaptive Exposure in Fluoroscopic Imaging
Published on: September 11, 2011
Protocol for reducing radiation exposure during pediatric thoracic radiography
Carla Daruich De Souza1, Gustavo Rico Freitas2, Rogério Fachel Medeiros3
1Laboratory for Radiation Therapy Sources Production, Nuclear and Energy Research Institute, Prof. Lineu Prestes Avenue, 2242 - Butantã, São Paulo, SP 05508-000, Brazil.
Introduction:
This work aims to assess if the anode position during chest radiography of pediatric patients with heart congenital disease (HCD) influences medical image results. The approach is to reverse the orientation of the x-ray tube, with the anode end directed towards the patient's face (anode-heel effect).
Methods:
Five specialists analyzed 48 images, 24 from the control group (CG) and 24 with the anode end directed towards the patients' face (experimental group, EC). An ionization chamber was used to assess radiation dose received by sensitive organs.
Results:
The specialists considered both CG and EC images acceptable. But, the EC group's dose evaluation revealed that the thyroid received 12% less radiation and the gonads presented a 5.9% reduction. Based on the results, a new protocol was developed.
Discussion/Conclusion:
The standardization of radiographic imaging procedures will reduce acquisition errors, resulting in adequate images in pediatric patients with HCD with less radiation dose, thus increasing patient safety and extending the life of the equipment.
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