LOW-DOSE RADIOGRAPHY OF SCOLIOSIS IN CHILDREN - A COMPARISON OF METHODS

Study Design. Records of 1,582 conventional and computed radiographic examinations performed to evaluate scoliosis were reviewed and compare d to determine differences in total radiation burden. Objective. This study evaluated the impact of computed radiographic imaging (CRI) on r adiation exposure in children undergoing serial spinal radiographs for scoliosis assessment and compared exposure from CRI with that of low- dose film-screen combinations. Summary of Background Data. CRI permits diagnostic radiographic studies to be performed with a dose reduction of 80%-95% compared to conventional film-screen systems. High speed f ilm-screen systems also permit a significantly lower exposure. Each ap proach has unique advantages and disadvantages. Methods. Over 6 years, we performed 1,582 spinal examinations in children 4-14 years old usi ng reduced dosage techniques with computed radiography. The images wer e obtained with Fuji FCR 101 and Philips PCR/SP systems. The adequacy of diagnostic image quality in the serial evaluation of scoliosis at d ifferent exposure levels was evaluated and compared with regular and f ilm-screen systems with speeds ranging from 250 to 1,200. Results. Dia gnostic-quality images for evaluating scoliosis can be obtained with d oses of 5% or less than required with conventional film-screen systems . Computed radiography provides image quality and dose reduction compa rable to a 1,200-speed film-screen system. Conclusion. CRI gives satis factory images at 5% reduction of the standard film-screen dose. Based on comparison with a 1,200 speed film-screen system, CRI provides equ al or better image quality at a similar radiation dose. The cost of CR I is higher than for film-screen radiography, but wide latitude and th e ability to tailor dose with requirements for image quality are signi ficant advantages for CRI.