A reduced micro-dose protocol for 3D reconstruction of the spine in children with scoliosis: results of a phantom-based and clinically validated study using stereo-radiography
Article dans une revue avec comité de lecture
Date
2019Journal
European Journal of RadiologyRésumé
Purpose The aim of this study was to validate the reproducibility of 3D reconstructions of the spine using a new reduced micro-dose protocol. Methods First, semi-quantitative image analysis was performed using an anthropomorphic child phantom undergoing low-dose biplanar radiography. This analysis was used to establish a “lowest dose” allowing for acceptable visibility of spinal landmarks. Subsequently a group of 18 scoliotic children, 12 years of age or younger, underwent full-spine biplanar radiography with both micro-dose and the newly-defined reduced micro-dose. An intra- and inter-observer reliability study of 3D reconstructions of the spine was performed according to the International Organization for Standardization (ISO)-5725 standard, with three operators. Results The reduced micro-dose setting corresponded to a theoretical reduction of radiation dose exposure of approximately 58%. In vivo results showed acceptable intra- and inter-observer reliability (for instance 3.8° uncertainty on Cobb angle), comparable to previous studies on 3D spine reconstruction reliability and reproducibility based on stereo-radiography. Conclusion A new reduced micro-dose protocol offered reliable 3D reconstructions of the spine in patients with mild scoliosis. However, the quality of 3D reconstructions from both reduced micro-dose and micro-dose was inferior to standard-dose protocol on most parameters. Standard–dose protocol remains the option of choice for most accurate assessment and 3D reconstruction of the spine. Still, this new protocol offers a preliminary screening option and a follow-up tool for children with mild scoliosis yielding extremely low radiation and could replace micro-dose protocol for these patients.
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