New surgical table provides up to 20% reduction in C-arm radiation exposure

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A comparative study performed to verify the new imagiQ2 low-dose table top from Stille has shown that the new device produces 20% lower radiation exposure than the previous model, imagiQ. The analysis was conducted at the Shoreline Surgical Associates Clinic, Middletown, USA, a clinic managed by vascular surgeon Joseph Coatti.

In recent years, there has been increasing concern regarding the radiation risks to both the patient and operator for fluoroscopy based interventional procedures. Mean fluoroscopy time in EVAR procedures have been reported in published studies to be in the range of 13–39.4 minutes, and procedures requiring large fluoroscopy times are associated with a significant radiation hazard.

Significant reduction in patient radiation dose can be achieved by changing radiological procedures, radiological equipment or both. Any reduction of the attenuation between the patient and the image receptor will have a beneficial effect on patient dose. Globally established guidelines and regulations by institutions as the International Atomic Energy Agency stipulate the fundamental principles of radiation safety which is to keep occupational radiation exposures “as low as reasonable achievable (ALARA)” and that equipment should be operated at the lowest fluoroscopic dose rate that yields adequate images.

The aim of the study was to assess how the new imagiQ2 surgical table with a low-dose table top may help to reduce radiation exposure relative to the industry standard table top of the first generation imagiQ table. The study was conducted using an abdomen phantom with human bone surrounded by acrylic plastic and a GE OEC 9900 C-arm unit. The phantom was placed in the centre of the fluoroscopy field on both surgical tables. The image intensifier was placed 15 inches from the table tops. A standard fluoroscopy exposure was made and data recorded.

The C-arm unit recorded 0.10mGy radiation exposure on the imagiQ and 0.08mGy on the imagiQ2. Image pictures were equal in resolution. The comparative study showed that the imagiQ2 table required 20% lower exposure than the imagiQ table at constant standard fluoroscopy set-up.

As compared to already published dose rates in EVAR procedures, a 20% reduction in radiation can be equivalent to more than 5.0mGy of reduced mean effective dose. “To put into perspective, this reduction equals the radiation exposure affecting the body from more than 250 conventional chest posteroanterior X-ray procedures. The study proved that the new imagiQ2 table can help reduce harmful radiation exposure and can be an important contributor of keeping dose exposure according to the ALARA principle,” Coatti said.

Industry standard surgical imaging tables report to have table top attenuation levels of 0.7–1.5mm Al, a variable which should be measured according to the medical device directives of the European Committee for Electrotechnical Standarization (CENELEC). The imagiQ2 with its 0.4 mm Al, is developed with a patent pending carbon fibre technology that has proven its extremely low attenuation.

The imagiQ2 table was introduced in 2012 and includes a new carbon fibre table top (patent pending) and free float (also pending patent).