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

• A. L/S
• B. L/S, retrograde urography, and abdominal angiography
• C. Retrograde urography
• D. Abdominal angiography

Answer: (B)

High bone marrow dose exams are those that irradiate the pelvic and lower-spine bone marrow, either because the area is the focus of the study or because the procedure involves long fluoroscopy times and repeated exposures in that region. The lumbar-spine radiography targets the vertebral bodies where red marrow is concentrated, so it contributes significant marrow dose. Retrograde urography concentrates X-ray exposure in the pelvic area to visualize the urinary tract, and the pelvic bones contain active marrow, leading to high marrow doses. Abdominal angiography involves prolonged fluoroscopy and multiple acquisitions to map abdominal vessels, delivering a substantial dose to the abdomen where pelvic bone marrow resides. Taken together, these procedures collectively produce the highest bone marrow exposure among typical radiologic exams.