Which of the following are considered high bone marrow dose examinations?

• A. Lumbar spine radiography and retrograde urography
• B. Lumbar spine radiography and abdominal angiography
• C. Retrograde urography and abdominal angiography
• D. Lumbar spine radiography, retrograde urography, and abdominal angiography

Answer: (D)

High bone marrow dose occurs when the imaging beam intersects regions rich in red marrow, especially the pelvis and spine, and when the study involves lengthy fluoroscopy or multiple acquisitions. The lumbar spine contains a large amount of active red marrow, so imaging the lower spine inherently delivers a relatively high dose to those marrow reserves. Abdominal angiography relies on prolonged fluoroscopy and repeated radiographic runs to visualize vessels throughout the abdomen and pelvis, exposing pelvic bone marrow to substantial radiation. Retrograde urography concentrates imaging in the pelvic region to evaluate the urinary tract, often with extended fluoroscopy and multiple images, again increasing the dose to pelvic marrow. Taken together, these three procedures collectively deliver high doses to bone marrow in the pelvis and spine, making all three high bone marrow dose examinations.