Patients are frequently exposed to numerous radiographs, during diagnosis and treatment, whether conservative or surgical, and follow-up.
Full spine imaging is often performed in young patients where radiation dose is of special concern.
In fact, frequent examinations involving ionizing radiations, even at low dose, lead to and increased risk of leukemia and brain cancer.
This phenomenon has been predicted in pediatric orthopedic patients treated for idiopathic scoliosis, hip dysplasia, and leg-length discrepancy.
Radiography plays a major role in confirming the initial diagnosis of idiopathic scoliosis and is essential for follow-up and the evaluation of curve progression over time.
During spine radiographs, radiosensitive organs such as the thyroid and breasts are exposed to radiation.
For children with idiopathic scoliosis, Presicutti et al. have reported that the mean number of radiographs per year was up to 12 for those undergoing surgical treatment, and 5.7 for those undergoing bracing treatment.
The cumulative radiation exposure due to periodic full spine radiographs in patients with idiopathic scoliosis has recently been estimated to 15 mSv, resulting in a significantly increased cancer risk, especially in females.
EOS low-dose radiographs (EOS imaging, Paris, France) allow diagnosis and follow-up of idiopathic scoliosis, since they allow 3D modeling of the spine in a weight-bearing position, with a significant reduction in radiation dose, compared to computed and digital radiograph.
Law et al. have shown that the maximal cumulative effective dose from an early onset patient undergoing semi-annual EOS full spine scan from 10 up to 18 years old was 1.85 mSv for girls and 1.52 mSv for boys, which was about seven times in using EOS system when compared with using digital imaging.
The aim of this preliminary study was to compare image quality and radiation exposure using two acquisition protocols (EOS standard dose protocol vs EOS micro dose protocol) for full spine radiation, in 140 patients.