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

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 is 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 purpose of our study was also to survey to what extent the radiographers are familiar with the capabilities of x-ray units, they operate and to survey the justification of such practice, whose main objective is to obtain diagnostic image quality with minimal patients exposure. The measurements were made on six different x-ray units, routinely used in five different hospital on the territory of Sofia. The result from 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 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.