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About Radiation Exposure & ALARA

Since nearly the beginning of its use, x-ray or fluoroscopic radiation was identified as a potential cause for a host of medical problems. Lessray offers the physician and hospital system the opportunity to use significantly reduced radiation imaging.

Fluoroscopy guided surgery is used in nearly all surgical procedures that require real-time image guidance. There are roughly 17 million fluoroscopic procedures performed in the United States on an annual basis. Since continuous monitoring is required during minimally invasive procedures, radiation exposure to the patient, physician, and staff is higher than other types of procedures.

Since nearly the beginning of its use, x-ray or fluoroscopic ionizing radiation has been identified as a potential cause for a host of medical problems and is a well-established cause for cancer, cataracts, cardiovascular disease, mental retardation in newborns, prenatal death and more. The FDA has identified all patients, physicians, technologists, and procedural operating room staff to be at a potential health risk when near or in close quarters to an x-ray source. It has been widely estimated that 2% of all of the newly diagnosed cancers in the United States are as a result of medical imaging. To handle this constant struggle with medical imaging dosage, physicians have come to adopt the principles of ALARA.

ALARA is the guiding principle in keeping ionizing radiation dosage "As Low As Reasonably Achievable." This principle helps minimize the harmful effects of radiation to patients and medical personnel while allowing medical interventions to save lives. But as with all things, there is a cost; with ALARA, the cost is image quality. The lower the radiation emitted by the fluroscope when taking an image, the worse the image quality, accuracy and safety for proceeding with the procedure. While all physicians strive to incorporate ALARA, the struggle with the risk of radiation exposure versus usable images is still at the forefront. To quote The American College of Radiology's Practice Guideline for General Radiology, physicians should work "to optimize the relationship between minimal radiation dose and adequate image quality."

Organized medicine continues to push for the use of low dose techniques and every major radiology group has jointly formed the Image Gently and Image Wisely coalitions to press all medical professionals and hospital systems to decrease radiation dose. These coalitions urge physicians, technologists, and anyone responsible for radiation exposure to "use the lowest pulse rate possible." But high yielding radiation reduction settings are not attainable if the x-rays produced are not usable by the physician.

The Solution: Lessray

Facts about Radiation Exposure

Patients
The exposure to x-rays during adolescence has been shown to double the risk of breast cancer in women.
"Breast Cancer in Women With Scoliosis Exposed to Multiple Diagnostic X Rays" Hoffman DA, Lonstein JE, Morin MM, Visscher W, Harris BSH, Boice JD, J Natl Cancer Inst 81:1307–1312, 1989
Fluoroscopic x-ray radiation can cause DNA damage, hair loss, burns, and necrosis potentially causing need for skin grafting.
"Fluoroscopically Guided Interventional Procedures: A Review of Radiation Effects on Patients' Skin and Hair" Balter S, Hopewell JW, Miller DL, Wagner LK, Zelefsky, MJ. Radiology: 254:2, February 2010
Physicians
Physicians can exceed their Lifetime Occupational Radiation Limit within the 1st decade of their career.
"Radiation exposure during pedicle screw placement in adolescent idiopathic scoliosis: is fluoroscopy safe?" Ul Haque M, Shufflebarger HL, O'Brien M, Macagno A. Spine: 2006 Oct 1;31(21):2516-20
Nearly half of all fluoroscopic orthopedic procedures expose the physician to enough radiation to increase the risk of thyroid cancer.
"Exposure of the thyroid to radiation during routine orthopaedic procedures" Devalia KL, Peter VK, Madanur MA, Braithwaite IJ. Acta Orthop. Belg., 2006, 72, 615-620
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