Quantitative imaging of the spine in adolescent idiopathic scoliosis: shifting the paradigm from diagnostic to comprehensive prognostic evaluation

Pasha, Saba; Rajapaske, Chamith R.; Reddy, Ravinder; Diebo, Bassel G.; Knott, Patrick; Jones, Brandon C.; Kumar, Dushyant; Zhu, Winnie; Lou, Edmond; Shapira, Nadav; Noël, Peter B.; Ho-Fung, Víctor; Jaramillo, Diego

doi:10.1007/s00590-021-02883-8

Cited by 6 publications

(8 citation statements)

References 96 publications

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“…The slot‐scanning system is the EOSedge system, 8 whose Flex Dose feature implements the AEC described in Section 2.1. The acquisition was performed using the full‐spine low‐dose protocol, in Flex Dose mode.…”

Section: Methodsmentioning

confidence: 99%

“…2 In addition, an increased usage of the EOS biplanar slot-scanning X-ray system (EOS Imaging, Paris, France, referred to as EOS-1st-generation system) has been reported for global postural assessments and follow-up of spinal deformities in care, with minimized patient exposure compared to planar radiography. [8][9][10][11][12][13][14] In particular, Damet et al 12 and Pedersen et al 13 measured organ dose distribution in the EOS-1st-generation system and demonstrated organ dose reduction using low-dose and microdose protocols compared to CR and DR. Yet, Pedersen et al 13 still advocated "continuously work [ing] towards minimizing the total radiation dose to which we expose our patients.…”

Section: Introductionmentioning

confidence: 99%

“…Currently, the main standard of care for follow‐ups of spinal deformities is planar radiography, which includes computed radiography (CR) or digital radiography (DR) 2 . In addition, an increased usage of the EOS biplanar slot‐scanning X‐ray system (EOS Imaging, Paris, France, referred to as EOS‐1st‐generation system) has been reported for global postural assessments and follow‐up of spinal deformities in care, with minimized patient exposure compared to planar radiography 8–14 . In particular, Damet et al 12 .…”

Section: Introductionmentioning

confidence: 99%

“…In 2019, EOS Imaging introduced the EOSedge system, embedding an AEC, called Flex Dose™ * 8,30 . The system aims at reducing patient dose while keeping a constant detector signal over the entire body.…”

Section: Introductionmentioning

confidence: 99%

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Performance of automatic exposure control on dose and image quality: comparison between slot‐scanning and flat‐panel digital radiography systems

Boissonnat

Morichau-Beauchant²,

Reshef³

et al. 2022

Medical Physics

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Background EOSedge™* (EOS Imaging, Paris, France) is an X‐ray imaging system using automatic exposure control (AEC) with tube current modulation, in order to optimize dose deposition in patients. Purpose This study aims at characterizing EOSedge organ dose deposition in comparison to a digital radiography (DR) system and the previous EOS system (EOS‐1st generation), in relation to their respective image quality levels. Method Organ doses were measured in an anthropomorphic female adult phantom and a 5‐year‐old pediatric phantom using optically stimulated luminescence (OSL) dosimeters, which were carefully calibrated within the studied energy range. Organ doses were recorded on the EOSedge and the Fuji Visionary DRF (Fujifilm Medical Systems U.S.A., Inc, Lexington, MA). The resulting effective doses were compared to the EOS‐1st‐generation values present in the literature. Image quality assessment was carried out on end‐user images. Quantitative image quality metrics were computed for all tested modalities on a quality assurance phantom. Qualitative assessment of EOSedge image quality was based on anthropomorphic phantom acquisitions against the EOS‐1st‐generation system, and on clinical images against the tested DR system. Results For a full‐spine exam, and on the female adult phantom (respectively, the pediatric phantom), an effective dose of 92 μSv (respectively, 32 μSv) was obtained on EOSedge, and 572 μSv (respectively, 179 μSv) on the DR system; these values were compared to effective dose values of 290 μSv (respectively, 200 μSv) from the literature on EOS‐1st generation, leading to an effective dose reduction factor of 6 with respect to the DR system, and of 3–6 with respect to EOS‐1st generation. EOSedge provides the best compromise between contrast‐to‐noise ratio (CNR) and dose, with more consistent CNR values than the other tested modalities, in a range of attenuation from 10 to 40 cm of poly(methyl methacrylate) (PMMA). Within this range, EOSedge is also comparable to DR for 10 and 20 cm of PMMA, and better than DR for 30 and 40 cm of PMMA, both in terms of spatial resolution and low‐contrast detection. The anatomical landmarks of interest in the follow‐up of spinal deformities can be detected in all tested modalities. Conclusion Results showed that EOSedge provides significant dose reduction factors for full spine imaging in both adults and children compared to the other tested modalities, without compromising image quality. We believe that this work could help raise awareness on the capabilities of modern X‐ray systems, when equipped with appropriate AEC strategies, to perform ultra‐low‐dose, long‐axis images.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Performance of automatic exposure control on dose and image quality: comparison between slot‐scanning and flat‐panel digital radiography systems

Boissonnat

Morichau-Beauchant²,

Reshef³

et al. 2022

Medical Physics

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show abstract

“…There is active research interest in performing radiation-free monitoring using US or surface tomography. 39 MRI is indicated in a patient with atypical scoliosis or when clinical findings are associated with an increased risk of a non-idiopathic cause (e.g., left thoracic curve, short segment curve, absence of apical segment lordosis, rapid curve progression). 37 Recent SOSORT recommendations suggest performing a whole-spine MRI in every child with a scoliosis diagnosis.…”

Section: Scoliosismentioning

confidence: 99%

Update on Pediatric Spine Imaging

Schatteman,

Jaremko,

Jans

et al. 2023

Semin Musculoskelet Radiol

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The spine is often difficult to evaluate clinically in children, increasing the importance of diagnostic imaging to detect a wide variety of spinal disorders ranging from congenital abnormalities to severe infections. Clinical history and physical examination can help determine whether imaging is needed and which imaging technique would be best. The most common cause for back pain, even in children, is muscular strain/spasm that does not require any imaging. However, red flags such as pain at age < 5 years, constant pain, night pain, radicular pain, pain lasting > 4 weeks, or an abnormal neurologic examination may require further investigation. Imaging can be of great value for diagnosis but must be interpreted along with the clinical history, physical examination, and laboratory findings to achieve an accurate diagnosis. We discuss imaging for the most common and/or important spine pathologies in children: congenital and developmental pathologies, trauma, infectious processes, inﬂammatory causes, and tumors.

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EOSedge vs. standard digital radiography: image quality and dose exposure in hip-focused scanning

Parret,

Herman,

Cyteval

et al. 2024

Arch Orthop Trauma Surg

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Quantitative imaging of the spine in adolescent idiopathic scoliosis: shifting the paradigm from diagnostic to comprehensive prognostic evaluation

Cited by 6 publications

References 96 publications

Performance of automatic exposure control on dose and image quality: comparison between slot‐scanning and flat‐panel digital radiography systems

Performance of automatic exposure control on dose and image quality: comparison between slot‐scanning and flat‐panel digital radiography systems

Update on Pediatric Spine Imaging

EOSedge vs. standard digital radiography: image quality and dose exposure in hip-focused scanning

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