by What is Fluoroscopy?
Fluoroscopy is a medical imaging technique that uses X-rays to obtain real-time moving images of the internal structures of a patient through the use of a fluoroscope. A fluoroscope allows the practitioner to see the internal structures and organs of a patient in motion. This can help guide procedures where imaging is important, such as cardiac catheterization or stent placement.
History of Fluoroscopy
Fluoroscopy dates back to the late 19th century and was one of the first medical imaging modalities developed after the discovery of X-rays in 1895 by Wilhelm Röntgen. Early fluoroscopy units used hand-held fluorescent screens and allowed doctors to see real-time moving images of patients’ internal structures and organs for the first time. Over the decades, technology improved vastly with the introduction of image intensifiers and digital flat panel detectors which dramatically increased image quality and enabled new applications. Today, modern fluoroscopy is an indispensable imaging tool widely used in cardiothoracic, orthopedic, vascular and urology procedures.
Components of a Fluoroscopy System
All modern Fluoroscopy Devices systems have several core components that work together to produce real-time moving X-ray images. The main components include an X-ray tube, collimator, image receptor or detector, and image intensifier. The X-ray tube produces the actual X-rays, while the collimator shapes and limits the size of the X-ray beam for patient safety. The image receptor detects the X-rays that pass through the patient and converts them into visible light images. Fluoroscopy units can have either an image intensifier where a video camera records the light images or a flat panel digital detector. The system processes and displays the live images on a monitor allowing physicians to see internal body structures and guide procedures.
Advancements in Image Quality
Significant technological advances over the past two decades have vastly improved the image quality of modern fluoroscopy systems compared to early generation models. Factors like higher X-ray tube power, more sensitive digital detectors, and post-processing tools all contribute to providing clearer and more detailed anatomical images. Images that were once grainy and low contrast can now show fine soft tissue detail in real-time. Also, newer fluoro units can acquire high resolution digital images during procedures and save them for later review, diagnosis and comparison. This enhances the diagnostic capabilities of fluoroscopy beyond just procedural guidance.
Reducing Patient Radiation Exposure
While fluoroscopy delivers indispensable clinical benefits, one drawback is the radiation exposure to patients from X-rays. However, modern systems have implemented many technologies that minimize radiation doses during examinations without compromising image quality. Some key methods include automatic brightness control to adjust X-ray outputs based on patient size, last image hold functions to freeze images and reduce fluoro times, and pulsed fluoroscopy modes that emit X-rays only during the image acquisition phase. Collimators precisely shape narrow X-ray beams and real-time dose monitoring helps optimize technical factors. Combined, these features enable fluoroscopy procedures to be performed safely with as low as reasonably achievable (ALARA) radiation levels based on each patient’s individual needs.
Advanced Imaging Technologies
To provide even better anatomical views and procedural guidance, some advanced fluoroscopy systems incorporate extra imaging technologies beyond the basic modes. These include 3D rotational angiography, where the X-ray tube and detector rotate around the patient for constructing volumetric images of blood vessels. Another example is ultrasound image fusion, which overlays real-time ultrasound scans onto fluoroscopy images for enhanced multi-modality guidance. Systems may also provide wireless connectivity for viewing images outside the exam room on laptops or mobile devices by multiple practitioners. Combined with sophisticated post-processing software, these state-of-the-art fluoro units enable advanced interventional procedures with exceptional multi-dimensional visualization capabilities.
Future Advancements in Fluoroscopy
Research is ongoing aimed at developing next generation fluoroscopy systems. Some potential areas of ongoing innovation include larger detector sizes and higher resolution flat panel displays for magnifying fine anatomical details. Technologies like needle tracking using electromagnetic fields or robotics may help guide device placement automatically. Also being explored is spectral imaging through energy-discriminating detectors to virtually “unmix” and visualize different tissues based on their material properties. Nanoparticle contrast agents under research may improve visualization of targeted tissues like tumors. While advancing digital capabilities, the goal still remains reducing radiation dosages through technologies like lower dose pulsed fluoroscopy or swapable X-ray sources emitting different energy spectra optimized for each exam type. Overall, fluoroscopy is likely to become even more valuable in the years ahead as technology continually enhances this staple interventional imaging tool.
*Note:
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
