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When the operator increased the magni cation women's health center in grants pass or cheap evista uk, a small increase of dose rate is necessary to womens health keller tx purchase evista 60 mg with visa overcome the increased impact of noise in the image breast cancer yard decorations purchase evista 60mg on line. The lower dose is a result of the minimization of the magni cation and maximization of the photon intensity hitting the detector because the spread out e ect of the beam is decreased. The result shows that increased frame rate also gives a higher dose level delivered to the patient, which is con rmed in the literature. The reason for using pulsed mode during interventional procedures is to over come motion artefacts from both the heart and the catheters. The total dose when performing uoroscopy with 30 frames per second is higher than the rest of the settings. But if the dose rate is divided by 30, the result show that the dose rate per images is lower than the the rest of the frame rate settings. From this it would be easy to make the conclusion that the dose delivered to the patient is increased when collimating. The fact that the eld size is reduced from 18-6 cm has to be considered in this case. The increased dose between the di erent collimation sizes is limited compared with the reduction of radiation area. The reason for this is that the scattered photons that produce random noise in the image is reduced when using collimation. The lowest dose rate is delivered using Test 1 with the strategy Max dose reduction, followed by Test 2 with frame rate 3. The table show that there is no signi cant di erence between the two groups except for the "Age" parameter, which is higher in the examinations before the change of the protocol. This is because there are two patients who reaches the maximum age of 89 years old in the test group using the old protocol. Fluoroscopic time is a direct contributor to dose and the di erence in dose between the two protocols could depend only on the the di erences in this factor and not on the change of protocol. The conclusion is that the result can not determine if the dose was decreased due to the change of protocol. The none signi cant result was not surprising due to the small sample size used in the pilot study. The conclusion is that the result obtained can not determine if the dose was decreased due to the change of protocol. The experiment were not isolated enough from the contributors and the changes were too small to make any visual di erence with such a small patient group. The study is a single center analyse where they compare data before they introduced their four-step" pro tocol" with data after the implementation. The change in frame rate is a very easy way of lowering the dose by a large number. Changing the frame rate from 15 to 7,5 could decrease the dose up to 50% by itself. The frame rate was not an option to change in this study because the operator already performed the procedures using frame rate of 7,5. They strictly used collimation, minimized the detector to patient distance in every new projection and used uoroscopic storage. A big reduction of dose was not possible and the change of dose rate settings of the protocol was not enough to show any signi cant di erences. The clinicians working in the hospitals are exposed to a huge amount of pressure both when it comes to time and performance. Implementing improvements focused on dose reduction is theoretically easy but when adding the factor that no mistakes are accepted and the workload that the clinicians live with every day it is not completely clear. Some implementations that make sense theoretically are hard to implement in the daily practice due to these limitations.
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