Table 8: Patients dose reduction techniques during ERCP.

Imaging parametersEquipment settings characteristicsERCP procedure

Increase tube voltageReduce image intensifier patient distanceExperienced examiners
Reduce fluoroscopic timeUndercouch configurationWell patient positioning and focusing prior the procedure
Reduce number of radiographic filmsFluoroscopy time with alarmRadiation barriers
Intermittent fluoroscopyLast image hold with digital featuresWear wrap-around lead aprons
Storing fluoroscopic imagesAdequate filtrationExaminers radiation safety training
Selection of the low-dose fluoroscopic modePulsed fluoroscopyExaminers and patient dose monitoring
Avoid magnificationRadiation control from inside the roomDose reference levels
Radiation field collimationAutomatic brightness control (ABC)Thyroid shields
Pulsed mode fluoroscopyMobile/suspended screenALARA principles (as low as reasonably achievable)