The Lixiscope is a portable, hand-held, fluoroscopic X-ray unit. The device incorporates an iodine-125 X-ray source and a small battery powered image intensifier.

The landed cost of the Lixiscope (duty free) in Australia is about $18,000. Each replacement of the radioisotope (whose useful life is about 4 months) costs approximately $2,000.  Annual renewal costs are therefore $6,000. These costs may be substantially reduced in the future by introduction of longer lived sources.

Although there are areas of concern, the Australian Radiation Laboratory has concluded that the use of the Lixiscope by a competent operator would not create a radiation hazard to the patient or operator.

The literature on this device reports uses in sports medicine, accident and emergency rooms, podiatry and orthopaedics.

The Panel has concerns that the nature, size and quality of the image could lead to misdiagnoses. For example, hairline fractures could be missed. Misdiagnoses could occur also if the device is used by persons untrained in radiological practice.

The Panel concludes that the effectiveness of the Lixiscope as a diagnostic tool has not been established, and considers that widespread use of this device is not justified.

Other portable fluoroscopic devices are being developed and marketed overseas.  The questions raised in respect of the Lixiscope should be similarly considered with these devices before any decisions are made on their distribution and use. In particular they should meet the following criteria:

  • the image should have adequate spatial and contrast resolution for the applications for which the device is intended.
  • the image  should neither be inverted not reversed.
  • scatter radiation reaching the patient and the user should be negligible.
  • permanent records of images should be readily obtainable.

The Panel recommends that:

  • the use of the Lixiscope and other portable imaging devices should be restricted to medical practitioners who have the appropriate licenses and expertise in radiation safety;
  • guidelines should be developed by users to ensure good radiological practice and security against theft and unauthorized use.
  • reimbursement for use of the Lixiscope should not be considered.