Comparison of Dose From Radiological Examination for Scoliosis in Children Among Two Pediatric Hospitals by Monte Carlo Simulation

Abstract

The radiation exposures of children undergoing full spine radiography were investigated in two pediatric hospitals in Greece. Entrance surface kerma (Ka,e) was assessed by thermoluminescence dosimetry and patient's effective dose (E) was estimated by Monte Carlo simulation. All required information regarding patient age and sex, the irradiation geometry, the x-ray spectra, and other exposure parameters (tube voltage and current) were registered as well. Values of Ka,e were measured to range from 0.22 mGy to 2.12 mGy, while E was estimated to range from 0.03 mSv to 0.47 mSv. In general, all values were greater in one of the two hospitals, as higher tube currents and exposure times were used in the examinations because of the difference in radiographers' training and practice. Moreover, dose to red bone marrow was found to be between 0.01 to 0.23 mSv and dose to breast ranged between 0.02 and 1.05 mSv depending on the age, projection, and hospital. These values are comparable with literature sources.

Radiography of scoliosis: Comparative dose levels and image quality between a dynamic flat-panel detector and a slot-scanning device (EOS system)

“…Total radiation risk is best quantified by the use of the effective dose, which is a reliable measure of the stochastic risk for the induction of cancer. The mean effective dose observed with one postero-anterior wholespine exposition, which covers a large part of the body and may be responsible for high cumulative doses, ranges from 0.05 to 0.5 mSv [10,11]. Supplementary lateral views and follow-up studies (up to 20 during adolescence) increase the cumulative effect and may be responsible for a significant dose delivered to the thyroid, breast and genitals.…”

Radiation exposure during scoliosis surgery: a prospective study

“…Several studies have examined the radiation exposure during the assessment of scoliosis patients [6][7][8][9][10][11][12]; however, we could identify only one previous study examining the intraoperative radiation exposure in children with FDA device/drug status: Not applicable. Author disclosures: NM: Nothing to disclose.…”

SOSORT 2012 consensus paper: reducing x-ray exposure in pediatric patients with scoliosis

“…The fact that these numbers were so drastically altered by adjusting the mechanics of the radiographic imaging led to the study’s recommendation to use PA films rather than AP films. Gialousis et al also found that the PA approach could reduce the increased risk of breast cancer in females treated for scoliosis [6]. …”