Which slot scanning device is best for low-dose radiographs in pediatric scoliosis? A pilot study.

IF 1.8 Q3 CLINICAL NEUROLOGY

Spine deformity Pub Date : 2025-08-09 DOI:10.1007/s43390-025-01159-z

Hans K Nugraha, Ria V Paradkar, Beth A Schueler, Zaiyang Long, Nathan C Hull, Stephen M Broski, Todd A Milbrandt, A Noelle Larson

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引用次数: 0

Abstract

Purpose: Studies have demonstrated a higher lifetime risk of cancer in AIS patients compared to age-matched controls. An asynchronous slot scan feature with ultra-small angle tomosynthesis reconstruction recently became available at our institution. Thus, we aimed to compare the performance of this new technology to the existing biplanar slot scanner for scoliosis imaging using standard dose settings.

Methods: All scoliosis patients under 18 years old from a single institution who underwent diagnostic imaging with both the asynchronous (True2Scale) and biplanar imaging system (EOS®) were included. Overall image quality was independently reviewed using a previously published method. Anthropomorphic phantom evaluations and dose measurements were conducted, with effective doses compared between systems. A computerized model based on phantom data estimated standardized patient effective doses.

Results: 40 imaging studies from 20 patients met the inclusion criteria. ICC for overall image quality was 0.88, with weighted-Cohen's Kappa analysis showing very high agreement (κ = 0.873). On average, patients imaged with the asynchronous system received 0.23 ± 0.15 (median: 0.10) mSv in each study, while patients imaged with the biplanar system received 0.12 ± 0.05 (median: 0.13) mSv. A bootstrap Welch's t-test showed a significant difference in mean radiation doses (p = 0.038, mean difference = 0.11 mSv, T2S higher than EOS). AP dose analysis showed no significant difference (p = 0.196), with the asynchronous system at 0.07 ± 0.03 (median: 0.07) mSv and biplanar at 0.06 ± 0.02 (median: 0.05) mSv.

Conclusions: Both technologies with standard dose parameters provided comparable image quality. While the asynchronous system delivers slightly higher radiation doses, both systems expose patients to less than annual background radiation (3 mSv) and standard 2-view scoliosis imaging doses. Larger studies are warranted to confirm these pilot findings.

Level of evidence: III-retrospective cohort study.

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小儿脊柱侧凸低剂量x线片最佳的槽位扫描设备是哪一种？一项初步研究。

目的：研究表明，与年龄匹配的对照组相比，AIS患者的终生癌症风险更高。一种具有超小角度断层合成重建的异步槽扫描功能最近在我们的机构可用。因此，我们的目的是比较这种新技术的性能与现有的双平面槽扫描仪的脊柱侧凸成像使用标准剂量设置。方法：所有来自同一机构的18岁以下脊柱侧凸患者均接受了异步（True2Scale）和双平面成像系统（EOS®）的诊断成像。使用先前发表的方法对整体图像质量进行独立审查。进行了拟人化幻影评估和剂量测量，并比较了系统之间的有效剂量。基于幻影数据的计算机模型估计了标准化的患者有效剂量。结果：20例患者的40份影像学研究符合纳入标准。整体图像质量的ICC为0.88，加权cohen 's Kappa分析显示非常高的一致性（κ = 0.873）。在每项研究中，采用异步系统成像的患者平均接受0.23±0.15（中位数：0.10）mSv，而采用双平面系统成像的患者平均接受0.12±0.05（中位数：0.13）mSv。bootstrap Welch’st检验显示，两组平均辐射剂量差异有统计学意义（p = 0.038，平均差值= 0.11 mSv， T2S高于EOS）。AP剂量分析差异无统计学意义（p = 0.196），异步系统为0.07±0.03（中位数：0.07）mSv，双平面系统为0.06±0.02（中位数：0.05）mSv。结论：两种技术在标准剂量参数下的成像质量相当。虽然异步系统提供略高的辐射剂量，但两种系统都使患者暴露于低于年背景辐射（3毫西弗）和标准双视图脊柱侧弯成像剂量的辐射。有必要进行更大规模的研究来证实这些初步发现。证据水平：iii级回顾性队列研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Spine deformity

CiteScore

3.20

自引率

18.80%

发文量

167

期刊介绍： Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.