Low-dose helical computed tomography (CT) in the perioperative workup of adolescent idiopathic scoliosis

Abstract

The study aims were to estimate the radiation dose in patients examined with low dose spine CT and to compare it with that received by patients undergoing standard CT for trauma of the same region, as well as to evaluate the impact of dose reduction on image quality. Radiation doses in 113 consecutive low dose spine CTs were compared with those in 127 CTs for trauma. The inter- and intraobserver agreement in measurements of pedicular width, and vertebral rotation, measurements of signal-to-noise ratio and assessment of hardware status were the indicators in the evaluation of image quality. The effective dose of the low dose spine CT (0.37 mSv) was 20 times lower than that of a standard CT for trauma (13.09 mSv). This dose reduction conveyed no impact on image quality. This low dose spine CT protocol allows detailed evaluation that is necessary for preoperative planning and postoperative evaluation.

Three-dimensional pelvic incidence is much higher in (thoraco)lumbar scoliosis than in controls

“…Because all scans were acquired preoperatively, only moderate to severe AIS curves, no mild AIS curves, were included in this study. Visualizing the femoral heads is not part of the standard low-dose (20 times lower than that of a standard CT for trauma) imaging protocol [23,24]. Therefore, only a small number of scans could be included for the purpose of this study.…”

“…Female patients with thoracic right convex and (thoraco)lumbar left convex AIS requiring surgery between August 2009 and May 2018 were included (demographics in Table 1). All had undergone preoperative supine low-dose (20 times lower than that of a standard CT scan) CT imaging of the spine at two institutions (Linkoping and Malmö, Sweden) [23,24]. The low-dose CT scan is part of the standard preoperative protocol in both centers.…”

Patients with adolescent idiopathic scoliosis of Lenke type-1 curve exhibit specific pedicle width pattern

“…A drawback of this study is that the measurements were performed by only one reader. The assessment of the reliability of CT in the measurement of the pedicle width is not the subject of this study as lowdose CT has previously been proved to be a reliable method in the measurements of pedicle width with an interobserver and intraobserver random error of difference of 0.3 mm [12]. Therefore, the measurements of this study were performed by only one reader who is experienced in We believe that our findings of the extreme pedicle narrowing at several vertebral levels among the majority of patients with Lenke curve type 1 (e.g.…”

“…The low-dose CT means a radiation dose of only 0.37 mSv per CT-examination covering 15 vertebral bodies (scan length of 36 cm) [12]. Sixty-one consecutive patients with AIS with Lenke type 1 curve (examined between January 2006 and September 2010) were included in this retrospective study.…”

“…Preoperative computed tomography (CT) or magnetic resonance imaging (MRI) enables the estimation of pedicle width, length and inclination. Low-dose spine CT with at least 20-fold reduction of the radiation doses has recently been introduced as a reliable method in the perioperative work-up of scoliosis [12]. Numerous reports on the pedicle morphometry in normal individuals as well as in cadavers and in patients with AIS have been published [13][14][15][16][17][18][19][20].…”