Aims and objectives
Scoliosis diagnosis and follow-up requires many full spine x-ray examinations performed along the late childhood and adolescence periods,
even quarterly along their puberal growth peak.
Retrospective population studies raised solid concerns that patients with scoliosis suffer an increased risk of breast cancer along their adult lives,
related to their prior breast x-ray exposures.
The risk of radiation-related breast cancer is higher for patients having female blood relatives with breast cancer than those who did not report such family history [1,
2].
Therefore,
different strategies to...
Methods and materials
Patient Population
Following an experimental prospective design,
80 paediatric patients (age 6 - 17 y) consecutively referred for antero-posterior full spine x-ray for diagnosis or follow-up of scoliosis,
were randomly assigned to 2 groups of 40 patients,
without excluding complex or post-surgical cases.
Patients with additional lateral projections were included for radiation exposure analysis.
Image acquisition
All were imaged with the same x-ray digital flat panel detector (Digital Diagnost,
Philips Medical Systems).
All exams were done in posterior-anterior projection,
without lateral collimation,
using digital stitching...
Results
73 patients had complete records available for image reading data analysis of PA images (table 1).
No significant differences in biometric parameters were found between both study groups populations:
Table 1
Group
n
Females
Age
Weight
Height
Cobb
Risser
Surgery.
A
40
30
13.7
49.4 kg
157 cm
28º
2.7
4
B
33
28
13.9
50.7
158
24º
2.6
2
Lateral views,
were obtained in 25 of 40 patients of group A,
and in 26 of 33 patients of group B. Lateral exposure data wereanalysed...
Conclusion
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 μGyand 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 ofFig. 1 and Fig. 2respectively):...
References
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Hanley JA,
Mayo NE,
Poitras B.
Projecting the lifetime risk of cancer from exposure to diagnostic ionizing radiation for adolescent idiopathic scoliosis.
Health Phys.
1994 Jun;66(6):621–33.
Ronckers CM,
Doody MM,
Lonstein JE,
Stovall M,
Land CE.
Multiple diagnostic X-rays for spine deformities and risk of breast cancer.
Cancer Epidemiol Biomarkers Prev.
2008 Mar;17(3):605–13.
Peters SE,
Brennan PC.
Digital radiography: are the manufacturers’ settings too high? Optimisation of the Kodak digital radiography system with aid of the computed radiography dose index.
Eur...