Optimisation of Radiation Exposure to Gastroenterologists and Patients during Therapeutic ERCP

Table 8

Patients dose reduction techniques during ERCP.

Imaging parameters	Equipment settings characteristics	ERCP procedure
Increase tube voltage	Reduce image intensifier patient distance	Experienced examiners
Reduce fluoroscopic time	Undercouch configuration	Well patient positioning and focusing prior the procedure
Reduce number of radiographic films	Fluoroscopy time with alarm	Radiation barriers
Intermittent fluoroscopy	Last image hold with digital features	Wear wrap-around lead aprons
Storing fluoroscopic images	Adequate filtration	Examiners radiation safety training
Selection of the low-dose fluoroscopic mode	Pulsed fluoroscopy	Examiners and patient dose monitoring
Avoid magnification	Radiation control from inside the room	Dose reference levels
Radiation field collimation	Automatic brightness control (ABC)	Thyroid shields
Pulsed mode fluoroscopy	Mobile/suspended screen	ALARA principles (as low as reasonably achievable)