Nuclear Associates CLEAR-Pb
Contents
1. Biomedical Nuclear Associates CLEAR Pb Transparent X Ray Compensation Filters For Spinal Radiography User Manual February 2005 Manual No 38609 Rev 2 2004 2005 Fluke Corporation All rights reserved All product names are trademarks of their respective companies Blank page Section 1 1 1 Section 2 2 1 Section 3 3 1 Section 4 4 1 Section 5 Table of Contents General Information rnnnnnnnnnnnnnnnnnnnnnnnnnennnnnnnnennnennnnennnennnnennne 1 1 MOGUCU EE NE NE VEE 1 1 Applications amp Specifications sasananananananannnnnnnnannnannnananenenansnannnnnnt 2 1 Applications amp SOCCHICATONS us 2 1 Filter Holder Mounting Instructions avararannnnnvnnnnnnnnnnvnnnnnnnnnnnnennnnn 3 1 Filter Holder Mounting Instructions rvrrrernrernvrrnnrernvrrnnrernvrnnvrnnnrennvennvennnee 3 1 Filter Positioning General a anavanannnnnnnnnnnnununununnnnnnnnnannnnnnnnnnnnununnn 4 1 Filler Posilioning General 4 1 Detailed Filter Positioning x axaxaxannnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnenennnnn 5 1 AP Full Spine 13 cm and Under Small to Average Patient 72 FFD 5 1 AP Full Spine 14 19 cm Above Average Patient 72 FFD 5 2 AP Full Spine 20 25 cm Large Patient 72 FFD 00220022200 5 4 AP Full Spine Over 25 cm Very Large Patient 72 FFD 5 5 AP Lateral Cervical Spine2. 57 407 Breast Shield 57 409 Figure 5 11 Sas Nuclear Associates CLEAR Pb Transparent Operators Manual Breast Shields 57 409 Lateral Thoracic Filter 57 407 Figure 5 12 5 7 Lateral Lumbar Spine 40 FFD Lateral Thoracic Filter 57 407 Gonad Shield 57 408 or 57 444 Used primarily on female patients where the hip measurement is 4 8 cm greater than the waist measurement Positioning Place the bottom edge of the filter just above the iliac crest Take measurement through the fifth lumbar vertebra see Figure 5 12 Lateral Thoracic Filter 57 407 Gonad Shield 57 408 or 57 444 Figure 5 13 5 8 Detailed Filter Positioning 5 Lateral Lumbar Spine 40 FFD Lateral Thoracic Filter 57 407 Gonad Shield 57 408 or 57 444 Figure 5 14 5 8 Lateral Full Spine Single Exposure Lateral Cervical Filter 57 406 Lateral Thoracic Filter 57 407 Breast Shield 57 409 Gonad Shield 57 408 or 57 444 Positioning When imaging the full spine in a single exposure position the Breast Shields 57 409 on top of the filter holder Slide the posterior shield out of the field of view Place the Lateral Cervical Filter on the shields with the top edge of the filter shadow projecting over the external auditory meatus The bottom edge should end at the level of C 5 Position the Lateral Thoracic Filter with its top edge 1 below the level of the axillary border see Figure 5 15 The
3. 57 408 or Build Up Filter metal side over 57 444 the AP PA Filter Figure 5 4 JD Nuclear Associates CLEAR Pb Transparent Operators Manual 5 3 AP Full Spine 20 25 cm Large Patient 72 FFD Breast Shields 57 409 Build Up Filter Thin 57 430 AP PA Wedge Filter 57 405 Gonad Shield 57 408 or 57 444 Position the top edge of the AP PA 57 405 Filter at the level of the external auditory meatus Attach the Breast Shields to the AP PA Wedge Filter bilaterally Place the Thin Build Up Filter 57 430 on top of the Breast Shields at the base of the nose see Figure 5 5 The measurement is taken in the AP position at the level of the third lumbar vertebra Thin Build Up Filter 57 430 AP PA Filter 57 405 AD er Breast Shield 57 409 Gonad Shield y 57 408 or 57 444 a i p l Figure 5 5 AP PA Filter 57 405 Breast Shields 57 409 Thin Build Up Filter 57 430 When using Build Up Filter 57 430 you might prefer first attaching the Breast Shields magnetic side to the filter holder rails then positioning the AP PA filter over the Breast Gonad Shield Shields and attaching the 57 408 or Build Up Filter metal side over 57 444 the AP PA Filter 5 4 Detailed Filter Positioning 5 AP Full Spine 20 25 cm Very Large Patient 72 FFD Figure 5 6 5 4 AP Full Spine Over 25 cm Very Large Patient 72 FFD Breast Shields 57 409 72 AP PA
4. 72 FFD rrrnnnnanennnnnnanevanennanennnrnnnnnnanennnnnnnnennn 5 6 Lateral Thoracic Spine 40 FFD siei a nn 5 7 Lateral Full Spine Single EXPOSUre cccsccccsseeeceeeeceeeeseeeeeeeeeseeeeseeeeeas 5 8 AP Thotacie Spine 40 EE ai aa nae sans en 5 9 AP Erect Abdominal Examination 40 FFD ooccocccccncccncccncccncccnnononanonos 5 10 Lateral Lumbar Spine L5 S1 Interspace 30 FFD ueeeeeeeeereereeeene 5 11 Sim Lateral SpOlIOn 07130 FED id 5 12 Shoulder 49 FED 5 13 Ribs 40 FFD ccccccssccecescesecesesesecsesececsescsecsessscsescsusecatsesscacsesscatseseceeeess 5 14 Blank page General Information 1 Introduction Section 1 General Information 1 1 INTRODUCTION CLEAR Pb Compensation Filters are made of a lead plastic material that is 30 lead by weight Since lead is an efficient absorber of x rays the filters will attenuate the x ray beam By varying the shape and thickness of the filters many combinations of filtering action can be achieved from almost complete attenuation to full penetration See Figure 1 1 Filter Figure 1 1 Filters Attenuate X ray Beam to Provide Even Exposure Throughout Image Area Figure 2 2 Collimator with Filter Holder 57 426 and AP PA Wedge 57 405 in Place Nuclear Associates CLEAR Pb Transparent Operators Manual CLEAR Pb Filters are transparent and lightweight By means of our Quick Stik system of magnetic strips on the filte
5. inferior aspect of the sacroiliac joints will be blocked on females This does not apply for use on males 6 When radiographing the sacroiliac region of an adult female use the smaller diameter Pediatric Gonad Shield 57 444 7 Double check the filter position before exposing the film 4 1 Nuclear Associates CLEAR Pb Transparent Operators Manual Blank page Detailed Filter Positioning AP Full Spine 13 cm and Under Small to Average Patient 72 FFD 5 Section 5 Detailed Filter Positioning 5 1 AP Full Spine 13 cm and Under Small to Average Patient 72 FFD Breast Shields 57 409 AP PA Wedge Filter 57 405 Gonad Shield 57 408 or 57 444 For smaller patients position the filter 1 above the level of the external auditory meatus This will result in reduced filtered exposure to the neck and upper chest See Figure 5 1 The measurement is taken in the AP position at the level of the third lumbar vertebra AP PA Filter 57 405 VN AR ma TAr ta Breast Shields 57 409 gt a Gonad Shield 57 408 or 57 444 Figure 5 1 gt Nuclear Associates CLEAR Pb Transparent Operators Manual AP PA Filter 57 405 57 408 or 57 444 Figure 5 2 5 2 AP Full Spine 14 19 cm Above Average Patient 72 FFD AP PA Filter 57 405 Build Up Filter Thin 57 430 Breast Shields 57 409 Adult Gonad Shield 57 408 or Pediatric Gonad Shield 57 444 For above average p
6. screw holes in these rails are off center turning the rails will set them 3 4 further apart If desired the magnetic tape on some or all of the filters can be cut to match the new position of the holder rails Using a sharp knife cut through the magnetic tape on each side of the filter in a line parallel to and 3 8 from the inner edge Remove this 3 8 strip leaving a 5 8 tape strip along the outer edge of the filter which matches the new position of the filter holder rails The use of the filters and holder is not changed by the above procedure De Nuclear Associates CLEAR Pb Transparent Operators Manual Figure 3 1 Screws Attach Mounting Plates to Filter Holder Cut mounting plates to size of accessory tray Filter holder cut to proper fit It slides into rails of collimator s accessory tray Beam exit window Figure 3 2 Figure 3 3 Turning the Steel Rails Increases Spacing Between Them 32 Filter Positioning General 4 Filter Positioning General Section 4 Filter Positioning General 4 1 Filter Positioning General This section contains a general description of filter positioning Read it thoroughly before continuing When performing examinations with 72 FFD a 14 x 36 cassette and preferably rare earth intensifying screens proceed as described below Sectional or multiple view radiographs on 14 x 17 or smaller films may also be taken with the same filter orientation Posi
7. Wedge Filter 57 405 Build Up Filter Thick 57 434 Build Up Filter Thin 57 430 Gonad Shield 57 408 or 57 444 Position the top edge of the AP PA Filter at the level of the external auditory meatus Attach the Breast Shields on top of the AP PA Wedge Filter Place the Build Up Filter thick on top of the Breast Shields with the top edge at the base of the nose Position the Build Up Filter thin on top of the Thick Build Up Filter to provide additional filtration for the odontoid process see Figure 5 7 An increase in technique is necessary as the patient measurement increases The measurement is taken in the AP position at the level of the third lumbar vertebra Thin Build Up Filter 57 430 Thick Build Up Filter 57 434 AP PA Filter I g 57 405 Breast Shield 57 409 Gonad Shield 57 408 or 57 444 Figure 5 7 ge Nuclear Associates CLEAR Pb Transparent Operators Manual AP PA Filter 57 405 Breast Shields 57 409 Thick Build Up Filter 57 434 Thin Build Up Filter 57 430 When using Build Up Filter 57 430 and 57 434 you might prefer first attaching the Breast Shields magnetic side to the filter holder rails then positioning the AP PA filter over the Breast Shields and attaching the Build Up Filter metal side over the AP PA Filter Gonad Shield 57 408 or 57 444 Figure 5 8 5 5 AP Lateral Cervical Spine 72 FFD 72 Non Bucky Lateral C
8. atients position the AP PA 57 405 filter 1 above the level of the external auditory meatus Place the Breast Shields 57 409 on top of the AP PA wedge 57 405 Place the Thin Build Up Filter 57 430 on top of the Breast Shields with the top edge of the filter at the mid portion of the chin midway between the inferior alveolar border and the mental protuberance See Figure 5 3 The purpose of the Build Up Filter is to increase the attenuation of the x ray beam in the cervical area This is necessary because exposure factors will have to be adjusted to properly expose the lumbar area due to increased abdominal density The measurement is taken in the AP position at the level of the third lumbar vertebra When using the Build Up Filters always position the steel slide against the magnet Magnet against magnet will result in filter movement due to repelling magnetic fields 32 Detailed Filter Positioning 5 AP Full Spine 14 19 cm Above Average Patient 72 FFD AP PA Filter gt 57 405 Thin Build Up Filter 57 430 Breast Shield p 57 409 Gonad Shield 57 408 or 57 444 gt Figure 5 3 AP PA Filter 57 405 Breast Shields 57 409 Thin Build Up Filter 57 430 When using Build Up Filter 57 430 you might prefer first attaching the Breast Shields magnetic side to the filter holder rails then positioning the AP PA filter over the Breast Gonad Shield Shields and attaching the
9. cal vertebra see Figure 5 23 Increase technique for C7 as required Lateral Thoracic Filter 57 407 Figure 5 23 Nuclear Associates CLEAR Pb Transparent Operators Manual Lateral Thoracic Filter 57 407 Figure 5 24 5 12 Shoulder 40 FFD Lateral Thoracic Filter 57 407 Position the patient as usual Place the Lateral Thoracic Filter so that its bottom edge covers the acromioclavicular joint see Figure 5 25 There is no change in technique Lateral Thoracic Filter 57 407 Figure 5 25 Detailed Filter Positioning 5 Shoulder 40 FFD Y ae As a KA Sein AAA tate y ea ap Ree DR To SS ry un gt ara Lateral Thoracic Filter 57 407 Figure 5 26 5 13 Ribs 40 FFD 40 AP PA Filter 57 405 The 40 AP PA Filter is used to even out densities in the chest cavity as it increases in size The thin end of the filter is in the caudad direction see Figure 5 27 How low the filter is positioned depends on the shape of the patient NOTE Filter is suggested for above diaphragm application only AP PA Filter 57 405 Figure 5 27 AP PA Filter OCIO A aa A NOONE LO Y AA SEE T an ir sia Mio Y Nuclear Associates CLEAR Pb Transparent Operators Manual Figure 5 28 5 16 Blank page Fluke Biomedical Radiation Management Services 6045 Cochran Road Cleveland Ohio 44139 440 498 2564 120 A
10. edge Filter is optional Filters purchased individually require a filter holder 56 426 to make them compatible with the x ray collimator One filter holder with mounting plates is recommended for each x ray machine All Filters have magnetic mounting strips at each end to attach to the matching steel rails on the filter holder AP PA Wedge Filter 72 FFD Model 57 405 Size 6 long x 2 4 wide x 3 8 thick weighs 6 oz AP PA Wedge Filter 40 FFD Model 57 415 Identical to Model 57 405 except that it is 4 1 8 wide weighs 10 oz Lateral Cervical Filter 72 FFD Model 57 406 6 Y long x 1 14 wide x 3 8 thick weighs 4 oz Lateral Thoracic Filter 72 FFD Model 57 407 6 Y long x 1 14 wide x 3 8 thick weighs 4 oz Breast Shields Model 57 409 3 long x 3 wide x 1 8 thick weighs 2 oz Will attach to Model 57 426 filter holder with or without the use of a filter Set of 2 pieces Build Up Filter AP PA Thin Model 57 430 6 Y long x 1 14 wide x 1 8 thick Has magnetic tape on one side steel on the opposite side to allow filter stacking weighs 2 oz Build Up Filter AP PA Thick Model 57 434 6 Y long x 1 14 wide x 9 32 thick Has magnetic tape on one side steel on the opposite side to allow for filter stacking weighs 3 oz Filter Holder Model 57 426 Clear plastic 6 wide x 5 2 long x 14 thick Has two steel rails 1 wide x 5 12 long for positioning filters and shields Only one filter holde
11. ensure that the filter holder will be in the proper position on the mounting plate If the final shape of the mounting plate is not square be sure to check for proper longitudinal orientation of the filter holder Figure 3 2 To cut the plastic mounting plate s use a plastic scoring knife Cut each plate separately Score the plastic at the desired locations making sure that each score runs the full length width of the plate Make the scores deep by going over each scratch several times Next place the scored plate over the edge of a table with the score mark on top and exactly above the edge Hold the plastic sheet flat to the table top with one hand With the other hand bend the overhanging part of the plastic sheet down If the score mark lines up exactly at the table edge the overhanging piece will break cleanly at the mark Check that the mounting plate slides easily into the accessory tray To make any fine adjustments needed for a proper fit use a file or fine sandpaper Re attach the filter holder to the mounting plate s and insert the assembly into the collimator s accessory tray Figure 3 2 If your collimator does not have an accessory tray the filter holder may be mounted with self stick Velcro type material This attachment kit Model 57 426 1100 is available from Fluke Biomedical If the steel rails on the filter holder intrude into the x ray field of view unscrew the rails and turn them around Figure 3 3 Since the
12. ervical Filter 57 406 For smaller or average size patients no filtration is needed For patients with broad shoulders the Lateral Cervical Filter 57 406 may be indicated Position it with the shadow of the top edge 1 above the level of the external auditory meatus The bottom edge should end at the level of the fourth cervical vertebra see Figure 5 9 Lateral Cervical Filter 57 406 Figure 5 9 5 6 Detailed Filter Positioning AP Lateral Cervical Spine 72 FFD 5 Lateral Cervical Filter 57 406 Figure 5 10 5 6 Lateral Thoracic Spine 40 FFD Lateral Thoracic Filter 57 407 Breast Shields 56 409 To best visualize the thoracic vertebrae the humeral heads should project anterior to the thoracic spine This is done by having the patient place the arms in front of the body with eloows bent and drawn together hands supinated perhaps resting on the IV pole to help stabilize the patient Attach the Breast Shields to the Filter holder assembly magnet to steel Place the Lateral Thoracic Filter on top of the Breast Shields The Lateral Thoracic Filter is placed to project 1 below the axillary border see Figure 5 11 Breathing technique is utilized Measurement is taken posterior to the humeral heads When imaging patients with kyphosis Take measurement through the kyphosis only to prevent overexposure Collimation 7 x 17 Slide posterior Breast Shield out of F O V Lateral Thoracic Filter
13. k edge projects over the patient s diaphragm Check that the thin edge of the filter is in the caudad direction see Figure 5 19 For use on patients with noticeable increased abdominal density Thick Edge AP PA Filter 57 405 Thin Edge Gonad Shield 57 408 or 57 444 Figure 5 19 Nuclear Associates CLEAR Pb Transparent Operators Manual AP PA Filter 57 405 Gonad Shield 57 408 or 57 444 Figure 5 20 5 11 Lateral Lumbar Spine L5 S1 Interspace 30 FFD Lateral Thoracic Filter 57 407 Position as the diagram indicates with the Filter on an angle to allow the top edge to be positioned through the body of the first lumbar vertebra and the bottom edge through the body of the fourth lumbar vertebra see Figure 5 21 Lateral Thoracic Filter 57 407 Figure 5 21 Detailed Filter Positioning 5 Lateral Lumber Spine L5 S1 Interspace 30 FFD Lateral Thoracic Filter 57 407 Figure 5 22 5 12 Slim Lateral Spot for C7 30 FFD Lateral Thoracic Filter 57 407 Filter the cervical spine above C7 for a more even density throughout the spine Position the patient in the lateral position Raise the arm closest to the film drawing it back under his head as far as possible Have the patient drop the opposite shoulder by moving his arm posterior to allow the head of the humerus to move posterior Position the filter on an angle so that the bottom edge of the filter covers the sixth cervi
14. lumbar area is unfiltered Technique should be set for the lumbar spine The Gonad Shield should be positioned as illustrated for males For females raise the shield 4 cm cephalad and 2 cm posterior Lateral Cervical Filter 57 406 Lateral Thoracic Filter 57 407 Breast Shield 57 409 Gonad Shield 57 408 or 57 444 Figure 5 15 39 Nuclear Associates CLEAR Pb Transparent Operators Manual Breast Plate 57 409 Lateral Cervical 57 406 Y gt Lateral Thoracic e es Filter 57 407 se gt N Gonad Shield 57 408 or 57 444 Figure 5 16 5 9 AP Thoracic Spine 40 FFD Breast Shields 57 409 AP PA Full Spine Filter 57 415 Gonad Shield 57 408 or 57 444 Position the 57 415 40 FFD AP PA Wedge Filter so that the shadow of the filter s thick edge is just above the external auditory meatus see Figure 5 17 The tapered section of the filter must be in the caudad direction Attach the Breast Shields 57 409 to both sides or the AP PA Wedge Filter Thick Edge AP PA Filter 57 405 Thin Edge Breast Shields 57 409 Gonad Shield _ 57 408 or 57 444 Figure 5 17 510 Detailed Filter Positioning 5 AP Thoracic Spine 40 FFD AP PA Filter 57 405 Breast Shields 57 409 Gonad Shield 57 408 or 57 444 Figure 5 18 5 10 AP Erect Abdominal Examination Position the 57 405 AP PA Wedge Filter so that the shadow of its thic
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16. r is needed per x ray machine Mounting Plates Model 57 411 Clear plastic 9 long x 9 wide x 1 16 thick Attached to filter holder with screws Easily cut to fit collimator assembly Two mounting plates are included with each filter holder assembly Zel Nuclear Associates CLEAR Pb Transparent Operators Manual Gonad Shield Adult Model 57 408 6 Y long x 1 wide x 1 16 thick Has a shamrock shaped 0 030 thick lead shield made up of three overlapping circles each Y2 diameter weighs oz Gonad Shield Pediatric Model 57 444 6 12 long x 1 wide x 1 16 thick Has shamrock shaped 0 030 thick lead shield made of three overlapping circles each diameter weighs oz Also for imaging sacroiliac region of adult female AP PA AP PA Lateral Lateral 72 FFD 40 FFD Thoracic Cervical Model No 57 405 57 415 57 407 57 406 Applications Full spine Full spine Lat full spine Lat cerv spine AP or PA AP or PA Oblique or AP Lat full spine AP or oblique esophagram with 57 407 Filter esophagram obese patients Lateral aortic arch Lateral chest Angiography of neck lower head may need 2 filters Length x Width 6 5 L x 2 25 W 6 5 L x 4 125 W 6 5 Lx 1 25 W 6 5 L x 1 25 W Max Thickness 0 1 0 1 0 15 0 3 Trough Width Configuration Filter Materials Plastic Lead Plastic 5 Magnetic Tape 22 Applications and Specifications D Applications and Specification
17. rs and a filter holder that slides into the collimator s accessory tray the filters can be held firmly in place and repositioned instantly See Figure 2 2 You can see and adjust the area and or degree of filter coverage as necessary Last minute positioning checks of the patient x ray collimator and filters are possible thanks to the filter transparency Selected area beam shaping has never been so simple and effective CLEAR Pb Filters should be used with a rare earth film screen combination to improve image quality and keep patient exposure to a minimum CLEAR Pb Compensation Filters are not compatible with gradient speed intensifying screens Consult your film manufacturer for the proper film screen combination This instruction manual provides typical suggested procedures for using CLEAR Pb Compensation Filters However individuals may modify this technique to suit their own requirements Applications and Specifications D Applications and Specifications Section 2 Applications amp Specifications 2 1 Applications amp Specifications The filters and accessories are available individually or as a set 57 445 The 57 445 CLEAR Pb X Ray Compensation Filter Set includes a multi purpose AP PA wedge filter 72 FFD a lateral cervical filter a lateral thoracic filter a pediatric and adult gonad shield a breast shield assembly two AP PA build up filters one thick one thin a filter holder and two mounting plates A 40 FFD AP PA w
18. s Build Up Build Up Breast Thin Thick Shields Model No 57 430 57 434 57 409 Additional filtration Full body shielding when imaging the full spine Permits vertical and horizontal adjustment of shielded area Additional Filtration to even to even out density out density in in cervical area cervical area 3 Lx3 W Length x Width 6 5 L x 1 25 W 6 5 L x 4 125 W Max Thickness 0 28 0 12 Configuration Filter Materials I Plastic iii Lead Plastic Magnetic Tape Applications Shield 2 5 Nuclear Associates CLEAR Pb Transparent Operators Manual Blank page Filter Holder Mounting Instructions 3 Filter Holder Mounting Instructions Section 3 Filter Holder Mounting Instructions 3 1 Filter Holder Mounting Instructions If the collimator housing has an accessory tray the two 9 x 9 X 1 16 acrylic mounting plates held together by 4 screws should be cut to fit the rails of the tray Figure 3 2 If the tray channel is less than 1 8 wide only one of the mounting plates is required The other should be removed and retained as a spare To separate the filter holder from the mounting plate s remove the four small screws holding them together Figure 3 1 Carefully measure the collimator s accessory tray and mark one or both of the mounting plates for cutting A cardboard template is recommended as a cutting guide Make a trial fitting with the template before cutting the plastic to
19. tion the patient cassette and x ray tube as usual 2 Attach the appropriate filter to the filter holder by the Quick Stik magnetic system The magnetic tape on the filters should align with the steel rails on the filter holder assembly Adjust to the proper height by sliding it up and down The transparency of CLEAR Pb filters allows the use or the collimator light However shadow lines or the filter edges are clearly identifiable to aid in correct placement Either side of the filter can be outward 3 Position the Breast Shields on top of the filter by attaching the steel side of the Breast Shields to the magnetic mounting material at both sides of the filter Please Note The Breast Shields may be used without a filter by simply attaching the magnetic side of the Breast Shields to the filter holder rails Also when using Build Up Filters 57 430 and or 57 434 you might prefer first attaching the Breast Shields magnetic side to the filter holder rails then positioning the AP PA Filter over the Breast Shields and attaching the Build Up Filter metal side over the AP PA Filter 4 Turnon the collimator light and position the filter so that the top edge of its shadow is at the level of the external auditory meatus 5 Position the Gonad Shield on the steel rails using the shadow projected on the patient Apply the shamrock shaped lead shield with the single leaf pointing cephalad for male patients and caudad for females NOTE The
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