Рентгенология & Радиология, 2019, LVIII 220-225

Role of the radiographer: the place of the fluoroscopy guided patient positioning in radiographer’s practice

  1. Gagova, D. Kostova-Lefterova, V. Chakarski


The use of fluoroscopy for patient positioning (fluoroscopy-guided positioning (FGP)) prior to performing x-ray examinations is prohibited in many countries around the world and also in Europe. However, in other countries, including Bulgaria, this is a common practice despite the numerous prohibitions and contrary to the university training of radiographers. The purpose of this study was to investigate the contribution of the FGP to the total patient dose during chest X-ray examinations and to survey the justification of such practice. The subject of our study was also to survey to which extent the radiographers are familiar with the capabilities of the X-ray units they operate and to survey their routine practice, whose main objective is to obtain diagnostic image quality with minimal patient exposure. The measurements were made on six different X-ray units, routinely used in five different hospitals on the territory of Sofia. The results of our measurements for the FGP practice showed that the patient dose increased from 19 to 285% for the different X-ray units and beam field sizes. The use of fluorography results in 141 ms exposure time for one of the X-ray units, compared to the recommendation of maximum 20 ms exposure for adult chest radiography. The use of FGP prior to general X-ray examination can be justified only in cases of patients with anatomical abnormalities in order to reduce the number of repetitive examinations due to wrong positioning as well as very complex projections for positioning.