Paul S. Babyn MD, Abstract Co-Author: Nothing to Disclose

Neda Faridian-Aragh MD, Presenter: Nothing to Disclose

Jennifer Stimec MD, Abstract Co-Author: Nothing to Disclose

Hadas Moshonov PhD, Abstract Co-Author: Nothing to Disclose

A recently developed ultra low dose slit scanning digital radiography system, EOS, offers advantages for pediatric scoliotic imaging. However, little information is available regarding its practicality in pediatric imaging. The purpose of this study was to evaluate the quality and artifacts of scoliotic spinal images of EOS as compared to computerized radiography (CR) in the pediatric age group.

In this retrospective study we evaluated the artifacts found on 200 EOS and 60 CR Agfa images of scoliotic spines, all acquired in the standing position. Full spine imaging by EOS is completed in approximately 10 seconds. For quality evaluation, 60 patients were chosen who had been imaged by both systems in a period of maximum 1 year. The mean age of the patients was 12.75 with a range of 5.5 and 17.5. Male to female ratio was 2.2/10. We developed a scoring system that used the degree of visualization of vertebrae, paravertebral soft tissue and lung parenchyma, as well as the level of homogeneity of the images to provide a single final score for each image. Two independent radiologists acquired this system to evaluate the quality of images.  

Artifacts with EOS consisted of: lucency adjacent to the heart and diaphragm in 94%, heart beat altering the heart’s shape in 85%, lucency adjacent to metallic density in 26% (100% of patients who had metal in their bodies), parallel linear densities in 24%, and miscellaneous artifacts in 18% of the images. No motion artifacts were noted. With CR we noted 5 different types of artifacts, the most important of which being due to filtering and stitching, noted in 100% of images. Filtering was found to be the major source of inhomogeneity in these images. Statistical analysis showed the quality score of EOS to be significantly higher than that of CR. There was no significant difference between the scores given by the two radiologists. No significant correlation was found between the patients’ age and the score of each modality.  

EOS not only uses lower Xray doses, but is also capable of producing images of higher quality than CR and can replace CR for the purpose of diagnosis and follow up of scoliotic patients.

EOS not only uses lower Xray doses, but is also capable of producing images of higher quality than CR and can replace CR for the purpose of diagnosis and follow up of scoliotic patients.

Babyn, P, Faridian-Aragh, N, Stimec, J, Moshonov, H, A Comparative Study of the Artifacts and the Quality of Scoliotic Spine Images Obtained by EOS and Computerized Radiography.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9015231.html