# Effect of Spectral Filtering and Segmental X-ray Tube Current Switch-Off on Interventionalist’s Scatter Exposure during CT Fluoroscopy

## TL;DR

This study shows that combining a tin filter and a technique called PACT can significantly reduce radiation exposure for doctors during CT fluoroscopy procedures.

## Contribution

The study demonstrates a novel combination of spectral filtering and segmental X-ray tube current switch-off to reduce scatter radiation for interventional radiologists.

## Key findings

- Using a tin filter and PACT together reduced radiation exposure in the upper body by 48%.
- The tin filter alone contributed about 8% to the overall dose reduction.
- The method is especially effective for protecting areas like the head/neck with limited standard protection.

## Abstract

Dose optimization in computed tomography (CT) is crucial, especially in CT fluoroscopy (fluoro-CT) used for real-time navigation, affecting both patient and operator safety. This study evaluated the impact of spectral X-ray filtering using a tin filter (Sn filter), and a method called partial-angle computed tomography (PACT), which involves segmentally switching off the X-ray tube current at the ambient dose rate H˙*(10) at the interventional radiologist’s (IR) position. Measurements were taken at two body regions (upper body: head/neck; lower body: lower legs/feet) using a 120 kV X-ray tube voltage, 3 × 5.0 mm CT collimation, 0.5 s rotation speed, and X-ray tube currents of 43 Eff.mAs (without Sn filter) and 165 Eff.mAs (with Sn filter). The study found significant dose reductions in both body regions when using the Sn filter and PACT together. For instance, in the upper body region, the combination protocol reduced H˙*(10) from 11.8 µSv/s to 6.1 µSv/s (p < 0.0001) compared to the protocol without using these features. Around 8% of the reduction (about 0.5 µSv/s) is attributed to the Sn filter (p = 0.0005). This approach demonstrates that using the Sn filter along with PACT effectively minimizes radiation exposure for the IR, particularly protecting areas like the head/neck, which can only be insufficiently covered by (standard) radiation protection material.