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ECR 2019 / C-3552
May we Further Reduce Dose in the Assessment of Full Spine Radiography in Children?
Congress: ECR 2019
Poster No.: C-3552
Type: Scientific Exhibit
Keywords: Image verification, Dosimetric comparison, Radiation safety, Dosimetry, Diagnostic procedure, Digital radiography, Radioprotection / Radiation dose, Paediatric, Musculoskeletal spine
Authors: J. Piqueras, J. C. Carreño, C. García Fontecha, A. M. VIVEROS CASTAÑO, M. A. Rios Vives, A. catala; Barcelona/ES


By using a simple optimized preset, the x-ray exposure in full spine radiography may be easily reduced by 50-70% in children, considering mean exposures of 168,25 μGy and 54,21 μGy for standard and optimized  technique, respectively. No increase in the exposure occurs in the lateral projections with both techniques.


In this low-dose images, with increased quantum mottle, image quality and anatomic detail are compromised as expected, impairing anatomic image detail, as can be recognized visually in the example images (zoom images of Fig. 1 and  Fig. 2 respectively): with standard dose Fig. 12 and with low dose Fig. 13. The latter has the features of an underexposed image.


Nevertheless, the degree of rater agreement was good for both techniques and suggest that even the optimized preset allows replicable measurements of the Cobb's angle and Risser’s grading, with good intra- and inter-observer agreement using the optimized low dose protocol.


No impairment in the radiological assessment of the magnitude of scoliosis has been detected. Risser grade agreement was good but inferior to angle agreement for both techniques, related to the higher variability reported in Risser's gradings in the literature [9, 10].


Our results suggest that this optimized low-dose protocol, with 50% to 70% dose reduction, allows reproducible scoliosis measurements, and can be used for postero-anterior full length spine radiography for scoliosis diagnosis and follow-up. 

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