Reducing radiation exposure and cancer risk for children with scoliosis: EOS the new gold standard.

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Rose, LD; Williams, R; Ajayi, B; Abdalla, M; Bernard, J; Bishop, T; Papadakos, N; Lui, DF (2023) Reducing radiation exposure and cancer risk for children with scoliosis: EOS the new gold standard. Spine Deform, 11 (4). pp. 847-851. ISSN 2212-1358 https://doi.org/10.1007/s43390-023-00653-6
SGUL Authors: Lui, Darren Frederick Kin Cheung

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Official URL: https://doi.org/10.1007/s43390-023-00653-6

Abstract

PURPOSE: Children are exposed to significant radiation doses during the investigation and treatment phases of scoliosis. EOS is a new form of low-dose radiation scan which also yields great image quality. However, currently its use is discouraged in the UK due to higher costs. We aimed to quantify the additional radiation dose and cancer risk. METHODS: We retrospectively reviewed all paediatric cases who received both standing whole spine roentgenograms and EOS scans as part of their investigations for scoliosis during a six-month period. We compared the radiation doses between the two modalities and estimated the additional mean lifetime cancer risk per study. RESULTS: We identified 206 children (mean age 14.4) who met the criteria of having both scans. Dose area products (dGycm2) were converted to estimated effective doses (mSv). The total mean doses were 0.68 mSv (PA 0.49 + Lat 0.19) for plain films, and 0.13 mSv (PA 0.08 + Lat 0.04) for EOS scans (p < 0.001). Additional lifetime cancer risk of a plain film was 543% greater than EOS for both sexes (1/10727 versus 1/5827 in males, 1/34483 versus 1/6350 in females). CONCLUSION: There is approximately 5.4-fold increase in risk of cancer for both boys and girls with roentgenograms over EOS, with girls being the most impacted. This carries a significant impact when considering the need for repeat imaging on additional lifetime malignancy risk in children. In our opinion, EOS dual planar scanning is the new gold standard when X-ray of the whole spine is required. LEVEL OF EVIDENCE: III.

Item Type:

Article

Additional Information:

© The Author(s) 2023 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Keywords:

Cancer, Children, EOS, Radiation, Risk, Safety, 0903 Biomedical Engineering, 1103 Clinical Sciences

SGUL Research Institute / Research Centre:

Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)

Journal or Publication Title:

Spine Deform

ISSN:

2212-1358

Language:

eng

Dates: