Fluoroscopy

General Description

Fluoroscopy is a medical procedure that provides real-time imaging of internal structures, organs, and tissues of the body in motion. It is a technique that can be used to diagnose diseases or to deliver treatments, particularly to facilitate certain surgical procedures.

Fluoroscopy is commonly used to observe the passage of food through the gastrointestinal tract, the way the lungs expand during respiration, or the movement of the heart as it beats.

Fluoroscopy uses X-rays to obtain images and, in most cases, also involves the administration of a contrast agent to enhance visualization of organs and tissues. Unlike conventional radiography, it captures multiple images per second (between 25 and 30), creating a motion picture effect that allows visualization of movement.

When is it indicated?

Fluoroscopy can be used in numerous situations both to determine the presence of abnormalities and to provide a more detailed view of the area where treatment is required. Its most common uses include:

• Barium enema or gastrointestinal transit study: shows the movement of the gastrointestinal tract.
• Cardiac catheterization: provides images of blood flow through the arteries and heart valves.
• Arthrography: provides images of the interior of joints.
• Angiography: facilitates the study of blood flow through peripheral arteries.
• Hysterosalpingography: allows assessment of the fallopian tubes and uterus.
• Urethrography or voiding cystourethrography: produces images of the urethra and bladder to evaluate urinary system function.
• Guidance for interventional procedures: such as angioplasty, pacemaker implantation, cardiac ablation, prosthesis placement, pain management through anesthetic injections applied directly to nerves, or biopsies.

How is it performed?

The procedure may vary depending on the type of fluoroscopy performed. Common steps include:

• The patient is positioned on the examination table in the most suitable position to optimize visualization of the area of interest.
• A contrast agent is administered, if necessary, orally, rectally, or intravenously.
• In surgical procedures where fluoroscopy is used as guidance, anesthesia is administered, either general or local.
• A continuous X-ray beam is directed at the specific organ; after passing through the tissues, it is captured by a computer that converts the information into moving images.

Risks

The amount of X-ray radiation used in fluoroscopy is minimal; therefore, it is generally considered to pose no significant health risk. However, risk depends on the duration of the procedure and the number of such examinations the patient undergoes. For this reason, exposure should be limited to what is strictly necessary, and appropriate measures should be taken to ensure that benefits outweigh potential risks.

In rare cases, allergic reactions to the contrast agent or anesthesia may occur.

In most cases, risks are more closely associated with the diagnostic or therapeutic procedures than with fluoroscopy itself.

Fluoroscopy is contraindicated in pregnant or breastfeeding women, as well as in patients with renal insufficiency or known contrast allergy.

What to expect from a fluoroscopy

When fluoroscopy is used as a diagnostic method, it is typically an outpatient procedure after which the patient can return home. Depending on the techniques applied, a period of rest may be required. When fluoroscopy is used as guidance during surgery, hospitalization is usually required for postoperative recovery.

Before undergoing fluoroscopy, informed consent must be signed. Patients are then required to remove jewelry and any other metallic objects and wear a gown provided by the medical center. In some cases, a lead apron is provided to protect pelvic organs from radiation exposure.

The patient may need to change position during the procedure to obtain clearer images of the structures being examined.

During the procedure, the patient remains alone in the radiology room, while specialists continuously monitor and observe their condition from an adjacent room.

The duration of fluoroscopy varies depending on the area of the body being examined and any associated procedures.

Specialties in which fluoroscopy is used

Fluoroscopy is performed by radiologists and is useful across multiple medical specialties, including Cardiology, General and digestive system surgery, Gynecology and Obstetrics, Assisted reproduction, Urology, Traumatology and Orthopedic surgery, Pulmonology, Medical oncology, and General surgery.