A systematic procedure to optimise dose and image quality for the measurement of inter-vertebral angles from lateral spinal projections using Cobb and superimposition methods

Article English OPEN
Al Qaroot, B ; Hogg, P ; Twiste, M ; Howard, D

BACKGROUND: Patients with vertebral column deformations are exposed to high risks associated with ionising radiation exposure. Risks are further increased due to the serial X-ray images that are needed to measure and asses their spinal deformation using Cobb or superimposition methods. Therefore, optimising such X-ray practice, via reducing dose whilst maintaining image quality, is a necessity.\ud \ud OBJECTIVES: With a specific focus on lateral thoraco-lumbar images for Cobb and superimposition measurements, this paper outlines a systematic procedure to the optimisation of X-ray practice.\ud \ud METHODS: Optimisation was conducted based on suitable image quality from minimal dose. Image quality was appraised using a visual-analogue-rating-scale, and Monte-Carlo modelling was used for dose estimation. The optimised X-ray practice was identified by imaging healthy normal-weight male adult living human volunteers.\ud \ud RESULTS: The optimised practice consisted of: anode towards the head, broad focus, no OID or grid, 80 kVp, 32 mAs and 130 cm SID.\ud \ud CONCLUSION: Images of suitable quality for laterally assessing spinal conditions using Cobb or superimposition measurements were produced from an effective dose of 0.05 mSv, which is 83% less than the average effective dose used in the UK for lateral thoracic/lumbar exposures. This optimisation procedure can be adopted and use for optimisation of other radiographic techniques.\ud \ud KEYWORDS: Cobb method; Optimisation of X-ray imaging; exposure dose reduction; image quality preservation; lateral thoraco-lumbar imaging; superimposition method
  • References (18)
    18 references, page 1 of 2

    [1] A. De Smet, S. Fritz, M. Asher, A method for minimizing the radiation exposure from scoliosis radiographs. The Journal of Bone and Joint Surgery 63 (1981), 156-61.

    [2] ICRP. Recommendations of the international Commission on Radiological Protection, Publication 26, Oxford, Pergamon Press. ICRP 1977.

    [14] J. Lescreve, R. Tiggelen, J. Lamoureux, Reducing the radiation dosage in patients with a scoliosis. International Orthopaedics 13(1989), 47-50.

    [15] A. Kalmar, P. Jones, R. Christopher, Low-Dose Radiography of Scoliosis in Children: A Comparison of Methods. Spine 19(1994), 48-54

    [16] C. Nash, E. Gregg, R. Brown, K. Pillai, Risks of exposure to X-rays in patients undergoing long-term treatment for scoliosis. J Bone Joint Surg Am 61(1979), 371-374

    [17] J. Hsu, J. Michael, J. Fisk, editors. AAOS atlas of orthoses and assistive devices. 4 ed. Phalidelphia, USA: Mosby Inc., 2008.

    [24] ICRP. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP Publication 103. Ann. ICRP 37 (2-4). 2007.

    [25] A. Whitley, Clark's positioning in radiography. London, UK: Hodder Arnold, 2005.

    [26] P. Hiles, A. Mackenzie, A. Scally, Recommended standards for the routine performance testing of diagnostic X-ray imaging systems. Institute of Physics and Engineering in Medicine 2005;Report No 91.

    [27] E. Trout, J. Kelley, V. Larson, A comparison of an air gap and a grid in roentgenography of the chest. American Journal of Roentgenology 124(1975), 404-11.

  • Metrics
    0
    views in OpenAIRE
    0
    views in local repository
    306
    downloads in local repository

    The information is available from the following content providers:

    From Number Of Views Number Of Downloads
    University of Salford Institutional Repository - IRUS-UK 0 306
Share - Bookmark