Division of Pediatric Radiology, Department of Radiology, Montefiore Medical Center, 111 E. 210th St., Bronx, NY, 10467, USA.
Carestream Health, Rochester, NY, USA.
Pediatr Radiol. 2021 Aug;51(9):1667-1675. doi: 10.1007/s00247-021-05022-x. Epub 2021 Mar 18.
A portable radiographic system capable of fluoroscopic imaging in the neonatal intensive care unit (NICU) potentially benefits critically ill neonates by eliminating the need to transport them to a fluoroscopy suite.
To evaluate whether a portable bedside fluoroscopy system in the NICU can deliver comparable image quality at a similar dose rate to a standard system in a fluoroscopy suite.
In phase A, 20 patients <3 years of age and scheduled to undergo upper gastrointestinal series (upper GI) or voiding cystourethrograms (VCUG) in the radiology fluoroscopy suite were recruited to evaluate a portable fluoroscopic unit. A modified portable radiographic system with a cassette-sized detector and an in-room fluoroscopy system were sequentially used in the same examination. Four radiologists compared the image quality of 20 images from each system using the Radlex score (1-4) for five image quality attributes. The radiation dose rates for the portable and in-suite systems were collected. In phase B, fluoroscopy studies were performed in 5 neonates in the NICU and compared to the 20 previous neonatal studies performed in the department. Clinical workflow, examination time, fluoroscopy time, scattered radiation dose and patient radiation dose were evaluated.
In phase A, average dose rates for in-room and portable systems were equivalent, (0.322 mGy/min and 0.320 mGy/min, respectively). Reader-averaged Radlex scores for in-room and portable systems were statistically significantly greater (P<0.05) for all attributes on the portable system except for image contrast. In phase B, scattered radiation from the average fluoroscopy time (26 s) was equivalent to the scattered radiation of 2.6 portable neonatal chest radiographs. Procedure time and diagnostic quality were deemed equivalent. The average dose rate in the NICU with the portable system was 0.21 mGy/min compared to 0.29 mGy/min for the in-room system.
The portable fluoroscopy unit is capable of providing comparable image quality at equivalent dose levels to an in-room system for neonates with minimal risks to the staff and other patients in the NICU.
在新生儿重症监护病房（NICU）中，一种能够进行透视成像的便携式放射系统通过消除将患儿转运至透视套房的需要，从而为重症患儿带来了潜在益处。
评估 NICU 中的便携式床边透视系统是否能够以与透视套房中标准系统相似的剂量率提供可比的图像质量。
在 A 阶段，招募了 20 名年龄小于 3 岁且计划在放射科透视套房进行上消化道系列检查（上 GI）或排尿性膀胱尿道造影（VCUG）的患者，以评估一种便携式透视设备。使用带有盒式探测器的改良便携式放射系统和室内透视系统，先后对同一检查进行了使用。四位放射科医生使用 Radlex 评分（1-4）对来自两种系统的 20 张图像的五个图像质量属性进行了图像质量比较。收集了便携式和室内系统的辐射剂量率。在 B 阶段，在 NICU 中对 5 名新生儿进行了透视研究，并与之前在该科室进行的 20 例新生儿研究进行了比较。评估了临床工作流程、检查时间、透视时间、散射辐射剂量和患者辐射剂量。
在 A 阶段，室内和便携式系统的平均剂量率相当，（分别为 0.322 mGy/min 和 0.320 mGy/min）。在所有属性上，除了图像对比度外，室内和便携式系统的读者平均 Radlex 评分均具有统计学显著差异（P<0.05）。在 B 阶段，平均透视时间（26 秒）的散射辐射与 2.6 张便携式新生儿胸部射线照片的散射辐射相当。操作时间和诊断质量被认为是等效的。与室内系统相比，便携式系统在 NICU 中的平均剂量率为 0.21 mGy/min，而室内系统为 0.29 mGy/min。
便携式透视系统能够在与室内系统等效的剂量水平下为新生儿提供可比的图像质量，而对 NICU 中的工作人员和其他患者的风险最小。
