Radiation exposure during ultrasound- and fluoroscopy-guided spinal interventional pain management procedures in dogs: a retrospective analysis in a single institution.

Abstract

OBJECTIVE: To quantify C-arm-registered radiation exposure during ultrasound- and fluoroscopy-guided spinal interventional pain management in dogs, and to measure operator-based radiation levels to identify discrepancies between delivered and received dose. STUDY DESIGN: A retrospective observational study. ANIMALS: A total of 82 canine spinal interventional pain management procedures performed at a single referral institution. METHODS: Radiation data [dose-area product (Gy·cm) and absorbed dose (mGy)] were collected from a mobile C-arm fluoroscopy system for procedures conducted from September 2020 to August 2024. Effective dose (mSv) was calculated using a standard conversion factor applied to dose-area product (Gy·cm). Operator exposure was monitored via thermoluminescent dosimeters (TLDs) placed at chest level and at the C-arm arc. TLD readings were retrieved quarterly through the Public Health England/UK Health Security Agency databases. The Shapiro-Wilk test was used to assess normality, and data were expressed as median (minimum-maximum) or mean ± standard deviation, as appropriate. RESULTS: The median absorbed dose for all spinal interventions was 3.97 (0.07-25.8) mGy. The corresponding median dose-area product and effective dose was 0.63 (0.01-4.12) Gy·cmand 0.15 (0.002-0.95) mSv, respectively. Procedural radiation exposure lay near the lower end of reported human ranges and operator TLD readings remained below detection thresholds despite cumulative procedural doses exceeding these levels. CONCLUSIONS AND CLINICAL RELEVANCE: Ultrasound- and fluoroscopy-guided spinal interventional pain management in dogs resulted in relatively low radiation exposure levels for both animals and operators. Incorporating ultrasound aligns with the 'as low as reasonably achievable' principle, helping reduce fluoroscopy time and associated risks. These findings support the development of targeted radiation safety protocols for veterinary interventional procedures and underscore the importance of continued operator training and dosimetry monitoring.