Impact of Replacing Old C-Arms on Reducing Radiation Exposure

Abstract Fluoroscopy is increasingly used by gastroenterologists for endoscopic procedures such as endoscopic retrograde cholangiopancreatography. Unfortunately, fluoroscopy exposes patients and staff to ionizing radiation, which can cause DNA damage, cell death, genetic defects, and cancer. These adverse effects are more likely to occur with increased exposure time and higher radiation doses; therefore, all efforts to decrease exposure are helpful. In this study, we investigate the impact that updating the C-Arms in our endoscopy unit will have on radiation exposure by comparing ionizing radiation effects of the OEC 9900 Elite to the newer OEC Elite. After replicating the setup of a typical endoscopic retrograde cholangiopancreatography, ionizing radiation and energy were measured at the bedside and the head of the bed with each machine. At both positions, the newer OEC Elite C-Arm emitted less energy and ionizing radiation than the OEC 9900 Elite. Continuous imaging with OEC 9900 Elite emitted 0.12 mSv/h at the head of the bed and 0.49 mSv/h at the bedside, while the OEC Elite only emitted 0.04 mSv/h and 0.14 mSv/h, respectively. These values are measures of radiation-induced cancer risk, otherwise known as stochastic risk. The differences grow more significant when extrapolated to show radiation differences for an average procedure (approximately 8 minutes of fluoroscopy time) and the procedural volume for an entire year. In an effort to use as little radiation as possible, we see that we can significantly reduce radiation exposure to our staff by upgrading from an OEC 9900 Elite to and OEC Elite.