Back to the list
Congress: ECR25
Poster Number: C-25431
Type: Poster: EPOS Radiologist (educational)
DOI: 10.26044/ecr2025/C-25431
Authorblock: S. Morkos, P. Melkonian, R. Abdallah, D. Abou Ltaif, F. H. Farhat, D. G. Jabbour, J. I. Berberi, C. Mourad; Beirut/LB
Disclosures:
Samer Morkos: Nothing to disclose
Patricia Melkonian: Nothing to disclose
Rita Abdallah: Nothing to disclose
Diana Abou Ltaif: Nothing to disclose
Fatima Hassan Farhat: Nothing to disclose
Diana Georges Jabbour: Nothing to disclose
Jessica Imad Berberi: Nothing to disclose
Charbel Mourad: Nothing to disclose
Keywords: Interventional non-vascular, Neuroradiology spine, Radioprotection / Radiation dose, CT, Radiation safety, Geriatrics, Quality assurance, Trauma
Learning objectives This study aimed to evaluate the effectiveness of a modified CT imaging protocol in reducing radiation exposure during CT-guided epidural, foraminal, and facet injections. Specifically, it assessed whether manually lowering kV and mAs settings could reduce radiation dose while maintaining needle tip visibility.
Read more Background CT-guided spinal injections are minimally invasive procedures used to treat pain by delivering medication, typically corticosteroids and local anesthetics, into the epidural space, neural foramina, or facet joints. At our institution, these procedures are performed under CT guidance, as it offers more precise needle positioning compared to fluoroscopy [1-5]. However, some concerns about radiation exposure remain.The necessity of dose reduction in CT-guided spinal injections stems from the need to minimize patient exposure to ionizing radiation while maintaining procedural efficacy. High...
Read more Findings and procedure details The average number of injections per procedure is 1.39, ranging from 1 to 4 injections. Epidural injections were the most common, totaling 106, followed by facet injections (84) and foraminal injections (38).The majority of patients received injections at a single vertebral level (152 patients). Seventeen patients received injections at two distinct spinal levels. Two individuals received injections at three distinct spinal levels.Amongst the patient population included in our study, 12 patients had orthopedic hardware.The Dose Length Product (DLP) in the...
Read more Conclusion The reduced kV and adjusted mAs protocol significantly decreased radiation exposure without affecting needle tip visibility during CT-guided injections. These findings suggest that dose-reduction strategies can be safely implemented in clinical practice to enhance patient safety without compromising procedural efficacy.
Read more References [1] Bogdanovic S, Sutter R, Zubler V. Spine injections: the rationale for CT guidance. Skeletal Radiol. 2023 Oct;52(10):1853-1862. doi: 10.1007/s00256-022-04188-1. Epub 2022 Sep 23. PMID: 36149474; PMCID: PMC10449983.[2] Barry PJ, Kendall PH. Corticosteroid infiltration of the extradural space. Ann Phys Med 1962;6:267–273.[3] White AH, Derby R, Wynne G. Epidural injections for the diagnosis and treatment of low-back pain. Spine (Phila Pa 1976) 1980;5(1):78–86.[4] Depriester, C., Setbon, S., Larde, A., Malaquin, E., Vanden Abeele, B., & Bocquet, J. (2012). CT-guided transforaminal...
Read more
GALLERY