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Description
The use of the surgical C-arm in orthopedic procedures is well established due to its ability to provide real-time fluoroscopic imaging, contributing to improved surgical precision and reduced operative time. However, scattered radiation represents a potential occupational risk to the medical staff, making it essential to understand its magnitude and angular distribution. This study evaluated the influence of metallic orthopedic implants (compression plate and intramedullary nail) on the angular distributions of scattered radiation in simulated fluoroscopy scenarios. Monte Carlo simulations were performed using the MCNP6.3 code [1] and the adult female MRCP anthropomorphic phantom [2]. The modeled radiation spectrum corresponded to a typical surgical C-arm beam, considering vertical and horizontal equipment configurations. Procedures involving the lower limb of the phantom were analyzed. The presence of metallic implants did not result in a significant overall increase in scattered radiation levels. Small angular redistributions were observed: a slight reduction in forward scattering (45°) and a modest increase in backscattering (120°), with maximum variations below 11% compared to the phantom without implants. Despite these localized differences, the overall angular distribution pattern remained essentially unchanged. These findings suggest that metallic implants do not constitute an additional relevant occupational risk factor in orthopedic fluoroscopy. Monte Carlo simulations proved valuable for detailed exposure assessment, although careful interpretation of quantitative differences is warranted.
[1] Kulesza et al 2022 Tech Rep LA-UR-22-30006
[2] Kim et al 2020 Ann ICRP 49 13-201