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Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
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Radiological investigations, including X-rays and computed tomography (CT) scans, are critical for diagnosing and evaluating various medical conditions. These imaging techniques provide valuable insights into the body's internal structures, aiding in the detection of abnormalities, assessment of disease progression, and development of treatment strategies. This article delves into two primary radiological investigations, chest X-rays and CT scans, outlining their purpose, procedures, and...
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Urinary Tract Calculi VI: Surgical Management01:25

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Imaging Studies VII: Vascular Imaging01:19

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DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...
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Related Experiment Video

Updated: Jul 12, 2025

Reduction of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease Combining Fiber Optic RealShape Technology and Intravascular Ultrasound
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Gel Rolls Increase Percutaneous Nephrolithotomy Radiation Exposure.

Mark D Sawyer1,2, Kayvon Kiani2, Jennifer R Stickel3,4

  • 1Surgical Services/Urology Section, Rocky Mountain Regional VA Medical Center, VA Eastern Colorado Health Care System, Aurora, Colorado, USA.

Journal of Endourology
|November 2, 2023
PubMed
Summary

Gel rolls significantly increase radiation exposure during percutaneous nephrolithotomy (PCNL) procedures. Using radiolucent positioning materials can help limit radiation doses for patients and surgical teams.

Keywords:
Artis Zeegogel rollsintraoperative CTpercutaneous nephrolithotomyprone PCNLradiation dosesupine PCNLthree-dimensional imaging

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Area of Science:

  • Urology
  • Medical Physics
  • Radiology

Background:

  • Reducing radiation exposure during endoscopic stone surgery is a growing concern.
  • Conflicting evidence exists regarding the impact of patient positioning (prone vs. supine) on radiation doses during percutaneous nephrolithotomy (PCNL).
  • Clinical observations suggested increased radiation with intraoperative CT imaging when patients were positioned prone on gel rolls.

Purpose of the Study:

  • To investigate whether gel rolls used for patient positioning in percutaneous nephrolithotomy (PCNL) directly increase intraoperative radiation doses.
  • To compare radiation doses associated with different positioning materials and techniques.

Main Methods:

  • Anthropomorphic experiments simulating PCNL positions were conducted using a robotic multiplanar fluoroscopy system.
  • A fluoroscopy phantom was positioned prone on gel rolls, blankets, or directly on the table, and in modified supine positions.
  • Dose Area Product (DAP) was measured and compared across various positioning scenarios, including the impact of C-arm direction and saline bag use.

Main Results:

  • Positioning prone on gel rolls resulted in a significant increase in measured DAP (146 μGy*m², 287%) compared to positioning on blankets of equal thickness (62.29 μGy*m², 23%).
  • Radiation doses varied considerably between experimental groups even when fluoroscopy time was constant.
  • The study found that gel rolls directly increase radiation dose, a finding not previously reported.

Conclusions:

  • Gel rolls used for patient positioning during PCNL procedures demonstrably increase radiation doses.
  • Surgeons should consider using radiolucent materials for patient positioning to minimize radiation exposure.
  • This finding has implications for patient safety and radiation management in urological surgery.