FREQUENTLY ASKED QUESTIONS - Fluoroscopy - Patients
Imaging tests allow doctors to see inside your body body to find health problems and plan treatment. Fluoroscopy is one type of test that uses x-ray or radiation to create the pictures. This booklet (or this part of the website) will help you understand the test you will have.
What is medical radiation?
There are several ways x-ray can be used to help your doctor find out what could be wrong. X-rays can be used for imaging or for treatment. These tests include X-rays, computed tomography (CT) scans, and nuclear medicine tests.
What is an x-ray?
X-rays can be used to create still pictures, like a camera, or to view the inside of the body in motion, similar to a video camera. The test that uses x-rays to see these parts of the body in motion like a video, is called fluoroscopy. For example, it can see your swallowing. X-rays are a type of radiation. In large amounts x-ray may cause damage to the body. In children, it is very important to use as low a dose of x-ray to get the information your doctor needs for your diagnosis or treatment.
Why is this test used for children?
Fluoroscopy is a good test that can show how the body parts work. This test shows what is happening in the body over several minutes or longer. Most of the body parts are not clearly seen unless your are given a substance called “contrast”. Contrast fills certain body parts to make them more easily seen. Contrast can given by mouth, by rectum, or by injection into a vein depending on what test your doctor requests. Contrast is usually safe, but rarely a child can have an allergic reaction to some types of contrast. If you have allergies or kidney problems, let your doctor know before the test is given.
These pictures can be saved on a computer, on a CD or on film, so that the test can be seen by other doctors. The gastrointestinal tract (esophagus, stomach, small and large intestines) and the urinary tract (bladder and kidneys) are the most common body parts to be tested in children. The upper GI tests require that you not eat or drink before the test. Ask your doctor if you can eat or drink before your test.
How much radiation is used in fluoroscopy examinations?
We are all exposed to small amounts of radiation daily from soil, rocks, building materials, air, water, and the sun. This is called natural background radiation, and the amount that we receive depends on where we live. For example, people living in high mountains are exposed to more radiation than people who live near the sea. The amount of X-ray used to get the pictures represents the radiation dose. Because every child is different in size and shape, different X-ray settings are used for each patient and test. One way of looking at doses is to compare X-ray tests is to the amount of radiation we receive every day, from soil, rocks, building materials, air, water and sun.
The chart below shows radiation doses for various tests compared to the sun and rocks around us called “background radiation”. The dose for your particular examination may be higher or lower.
|Non-Medical Radiation Source
||Radiation Dose Estimate
|Natural background radiation = 3mSv/yr||3 mSv||1 year
Airline passenger (cross-country)
|0.04 mSv||4 days|
|Medical Radiation Source
||Radiation Dose Estimate
||Equivalent Amount Background
|Chest x-ray||0.1 mSv||10 days|
|Urinary tract fluoroscopy (VCUG)|
|Infant||0.8 mSv||3 months|
|Child (5-10 yrs)||1.6 mSv||6 months|
How can we lower the radiation during the examination?
To decrease the amount of X-ray, newer types of equipment can give the X-rays in short amounts or pulses. This will lower the dose. Covering up parts of the body with lead shields can sometimes be used. The shields can only be used if they do not cover up the body part your doctor is trying to see. The Image Gently Campaign would like doctors who give the imaging test to:
- Use imaging tests when it is clear it will help you
- Use the best imaging test, and match it to your age and size
- Use other imaging test(such as ultrasound or MRI) when possible
If my doctor requests a fluoroscopic test, should I have it?
In most cases, the benefits of using the fluoroscopy test to find out the cause of your problem are worth the possible risk which could be associated with the X-ray test. Fluoroscopy is sometimes the only way your doctor can learn the cause of your problem. Often, this test can solve problems faster and with less possible discomfort than other tests. It is important to remember that if you are sick, you should have the tests that you need, after your questions or your parents’ questions have been answered. You parents can ask the doctor who will do the test for your child how they will keep X-ray doses low.
Ultrasound and MRI are other tests that do not use radiation, but these tests may not be able to answer your doctor’s question. If you need to have a fluoroscopy test, you may want to ask your doctor if there are any other tests that can be used instead.
How can I be sure that my hospital uses as low a radiation test as possible?
The best way to be sure if your hospital is using lower dose X-ray tests is to ask. It is your right to ask this question.
If I still have concerns regarding radiation to my child during fluoroscopy, whom should I talk to?
You or your parents should first discuss your concerns with the doctor who is wanted this test done. Doctors must balance the small risks to the benefits of getting the necessary information. Your pediatric doctor and your radiologist ( X-ray doctor) can work together to get the best test for you. The information contained in this booklet should not be used as a substitute for the medical care and advice of your doctors.
Image Gently is the educational and awareness campaign created by the Alliance for Radiation Safety in Pediatric Imaging, formed in July 2007. It is a coalition of health care organizations dedicated to providing safe, high quality pediatric imaging nationwide. The Society for Pediatric Radiology, American Society of Radiologic Technologists, American Association of Physicists in Medicine, American College of Radiology, and over 50 other North American and internaltional medical societies are members of this coalition, representing more than 600,000 health care professionals in radiology, pediatrics, medical physics, and radiation safety around the world. More information can be found at www.imagegently.org.
Susan John, MD
Ceela McElveny ELS, CLE