Research article – Optimisation of paediatrics computed radiographyfor full spine curvature measurements using a phantom: a pilot study

Seraphine de Haan, Cláudia Reis, Junior Ndlovu, Catarina Serrenho, Ifrah Akhtar, José Antonio Garcia, Daniël Linde, Martine Thorskog, Loris Franco, Peter Hogg

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Abstract

Aim: Optimise a set of exposure factors, with the lowest effective dose, to delineate spinal curvature with the modified Cobb method in a full spine using computed radiography (CR) for a 5-year-old paediatric anthropomorphic phantom.
Methods: Images were acquired by varying a set of parameters: positions (antero-posterior (AP), posteroanterior (PA) and lateral), kilo-voltage peak (kVp) (66-90), source-to-image distance (SID) (150 to 200cm), broad focus and the use of a grid (grid in/out) to analyse the impact on E and image quality
(IQ). IQ was analysed applying two approaches: objective [contrast-to-noise-ratio/(CNR] and perceptual, using 5 observers. Monte-Carlo modelling was used for dose estimation. Cohen’s Kappa coefficient was used to calculate inter-observer-variability. The angle was measured using Cobb’s method on lateral
projections under different imaging conditions.
Results: PA promoted the lowest effective dose (0.013 mSv) compared to AP (0.048 mSv) and lateral (0.025 mSv). The exposure parameters that allowed lower dose were 200cm SID, 90 kVp, broad focus and grid out for paediatrics using an Agfa CR system. Thirty-seven images were assessed for IQ and
thirty-two were classified adequate. Cobb angle measurements varied between 16°±2.9 and 19.9°±0.9.
Conclusion: Cobb angle measurements can be performed using the lowest dose with a low contrast-tonoise ratio. The variation on measurements for this was ±2.9° and this is within the range of acceptable clinical error without impact on clinical diagnosis. Further work is recommended on improvement to
the sample size and a more robust perceptual IQ assessment protocol for observers.
Original languageEnglish
Title of host publicationOPTIMAX 2014 – radiation dose and image quality optimisation in medical imaging
Place of PublicationLisbon, Portugal
Pages44-53
ISBN (Electronic) 9781907842603
Publication statusPublished - 2015
EventOPTIMAX 2014: radiation dose and image quality optimisation in medical imaging - Lisbon , Portugal
Duration: 1 Aug 201431 Aug 2014

Seminar

SeminarOPTIMAX 2014
CountryPortugal
CityLisbon
Period1/08/1431/08/14

Keywords

  • optimisation
  • spinal curvature measurements
  • effective dose
  • image quality
  • paediatrics
  • imaging phantom
  • computed radiography

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    de Haan, S., Reis, C., Ndlovu, J., Serrenho, C., Akhtar, I., Garcia, J. A., Linde, D., Thorskog, M., Franco, L., & Hogg, P. (2015). Research article – Optimisation of paediatrics computed radiographyfor full spine curvature measurements using a phantom: a pilot study. In OPTIMAX 2014 – radiation dose and image quality optimisation in medical imaging (pp. 44-53).