Chetan C. Shah MBBS, Presenter: Nothing to Disclose

Shilpa Hegde MD, Abstract Co-Author: Nothing to Disclose

Larry Thomas, Abstract Co-Author: Nothing to Disclose

Raghu Hosahalli Ramakrishnaiah MBBS, FRCR, Abstract Co-Author: Nothing to Disclose

Ulrich Neitzel PhD, Abstract Co-Author: Employee, Koninklijke Philips Electronics NV

S. Bruce Greenberg MD, Abstract Co-Author: Speakers Bureau, Toshiba Corporation Consultant, Vital Images, Inc

Charles Mack Glasier MD, Abstract Co-Author: Nothing to Disclose

Modern imaging with digital radiography and wide-detector computed tomography have the potential to reduce radiation exposure. Our purpose was to estimate absorbed radiation dose for imaging the pediatric cervical spine with digital radiography and wide-detector computed tomography technique.  

Radiation dose was retrospectively calculated for 102 children who underwent both digital radiography and 320 slice CT of the cervical spine. For digital radiography,radiation was measured using an ionization chamber exposure at 40 inches and at 80, 100 and 120 kVp. AP radiographs were performed at 40 inches and lateral radiographs were performed at 72 inches. A 3 mm aluminum filter was used. Radiation exposure was converted to absorbed dose using published conversion factors. Children under 5 years had wide detector acquisition CT at 80 KVp. Older children were scanned at 100,120 or rarely 135kVp using helical or wide detector technique. The CT scanner provided CTDI and DLP calculations. DLP was converted to absorbed radiation dose using published conversion factors. A literature search was performed to compare published radiation doses. T tests compared significant differences of techniques..

Average radiation dose for AP radiography was 0.035 mSv (SD = 0.04), open mouth view 0.045 mSv (SD = 0.05), and lateral radiography 0.004 mSv (SD = 0.006).  Previously reported radiation doses for adult AP radiography were as high as 0.12 mSv and for lateral radiography up to 0.02 mSv; 3.6 times the equavilant dose for a 2 view study performed using digital imaging. No published  paper for pediatric cervical spine dose was identified. The wide-detector  CT scan  average radiation dose was  0.87 mSv (SD = 0.38) and for  helical CT 8.68 mSv (SD = 8.1).  The wide-detector technique significantly reduced radiation exposure (p<0.00001).  Radiation dose for CT of children under 5 years was always less than 1 mSV. No previous reports of pediatric cervical spine CT dose were found.

Digital radiography of the cervical spine uses a reduced dose compared to prior reports using film-screen technique.  Wide-detector CT of the cervical spine uses < 1 mSV of exposure in children under 5 years of age.

Digital radiography  for cervical spine evaluation results in lower radiation dose than prior reports using film-screen technique. Wide-detector cervical spine CT reduces dose compared to helical CT.

Shah, C, Hegde, S, Thomas, L, Ramakrishnaiah, R, Neitzel, U, Greenberg, S, Glasier, C, Reduction of Absorbed Radiation Dose for Pediatric Cervical Spine Digital Radiography and Wide-Detector Computed Tomography.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12022575.html