Fluoroscopy-guided versus CT-guided Lumbar Steroid Injections: Comparison of Radiation Exposure and Outcomes The mean effective radiation dose for patients is lower for fluoro-scopically-guided.

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Fluoroscopy-guided versus CT-guided Lumbar Steroid Injections: Comparison of Radiation Exposure and Outcomes The mean effective radiation dose for patients is lower for fluoro-scopically-guided compared to CT-guided lumbar spinal injections (0.24 mSv vs. 0.33 mSv, p< 0.003). The mean radiation exposure for interventionalists is higher during fluoroscopically-guided procedures compared to CT-guided facet joint injections (Body: 0.42 x 10-3 mSv vs. 0.11 x 10-3 mSv, p<0.03). Visual abstract slide Fig 6 Illustration of imaging-guided injection techniques: Interventionalists stayed within fluoroscopy room (position 1) and CT room (position 1, position 2) during injection procedures to track the injection needle path. If technically feasible, interventionalists briefly left the fluoroscopy room (position 2) during fluoroscopy and went to the control room in order to observe the ALARA principle. For CT procedures, interventionalists’ preferable position was at the side of the gantry (position 2) for most of the image acquisitions because the radiation exposure tends to be below a measurable threshold at this particular location. CT technologists were not inside fluoroscopy or CT rooms during imaging-guided injections. Implications for patient care (1) The mean effective radiation dose for patients is lower for fluoroscopically-guided compared to CT-guided lumbar spinal injections. (2) The mean radiation exposure for interventionalists is higher during fluoroscopically-guided procedures compared to CT-guided lumbar transforaminal epidural and lumbar facet joint injections. (3) The imaging-guided injection technique, whether fluoroscopy or CT-guided, did not have an impact on patient outcomes. Illustration demonstrating where the interventionalist stayed within the fluoroscopy room and CT room account for the differences in the radiation exposures. Dietrich TJ et al. Published Online: Jan 8, 2019 https://doi.org/10.1148/radiol.2019181224