Which factor will increase patient dose during fluoroscopy?

The increase in patient dose during fluoroscopy is primarily influenced by the distance between the radiation source and the patient's skin, known as the source-to-skin distance (SSD). When the SSD is decreased, the radiation intensity at the patient's skin surface increases, leading to a higher dose of radiation delivered to the patient. This is due to the inverse square law, which states that the intensity of radiation is inversely proportional to the square of the distance from the source. As you decrease the distance, the radiation exposure increases significantly.

In contrast, increasing the SSD would result in a lower dose, as the radiation would be more dispersed and less intense by the time it reaches the patient. The use of 2.5 mm of aluminum filtration is designed to reduce patient dose by absorbing lower-energy photons that contribute less to image quality but more to patient exposure. Restricting tabletop intensity to less than 100 mGya/min would also reduce the dose that the patient receives, as it limits the maximum radiation output. Thus, only a decrease in the source-to-skin distance will inherently lead to an increase in patient dose during fluoroscopy.