Evaluation and Comparison of Entrance Skin Dose in the Imaging of Hip Region Using Computed Tomography (CT) Scan and Stereoradiography

Document Type : Original Article (s)

Authors

1 MSc Student, Department of Medical Physics, School of Medical Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Assistant Professor, Department of Medical Physics, School of Medical Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

3 Professor, Department of Orthopedic Surgery, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

4 Associate Professor, Department of Radiology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

5 Professor, Department of Medical Physics, School of Medical Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Abstract

Background: Extensive use of computed tomography (CT)-scan imaging is associated with an increase in cumulative dose. Stereoradiography by electro-optical system (EOS) is an X-ray imaging technology that can reduce patient absorption dose, and increase image quality by removing scattered radiation. The aim of this study was to quantify the dose of radiation in CT-scan and stereoradiography imaging, and to compare the dose values between the two methods.Methods: This descriptive-analytical study was carried out in the Shahid Sadoughi hospital of Yazd City, Iran, with two different types of imaging apparatus, stereoradiography and CT-scan. Fifteen patients were selected randomly for each imaging method. Prior to irradiation, nine thermoluminescence dosimeters (TLDs) were installed on the target area in anterior-posterior (AP), right transverse (RT), and left transverse (LT) views. 85-110 and 120 kilovoltage peaks (kVp) were used for stereoradiography and CT-scan, respectively. The TLDs were read, and the mean dose of radiation was calculated. Finally, the statistical analysis was performed using one-way ANOVA method via SPSS software.Findings: The mean dose of radiation in stereoradiography imaging from the lower regions with AP, RT, and LT views were 0.75, 0.26, and 1.14 mGy, respectively. These values with similar views in CT-scan images were 18.08, 10.87, and 10.37 mGy, respectively. According to the results of statistical analysis, radiation dose in the all views of stereoradiography imaging was significantly lower than CT-scan.Conclusion: Using stereoradiography imaging instead of CT-scan impose a lower dose to the patient in detecting lower limb malformations, and thus reducing the risk of cancer and side effects.

Keywords


  1. Linsenmaier U, Rieger J, Brandl T, Rock C, Niethammer M, Scherf C, et al. New method for fast spiral CT of trauma patients: RUSH CT. Emerg Radiol 2000; 7(3): 135-41.
  2. Pearce MS, Salotti JA, Little MP, McHugh K, Lee C, Kim KP, et al. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet 2012; 380(9840): 499-505.
  3. Victor J, Van Doninck D, Labey L, Van Glabbeek F, Parizel P, Bellemans J. A common reference frame for describing rotation of the distal femur: a ct-based kinematic study using cadavers. J Bone Joint Surg Br 2009; 91(5): 683-90.
  4. Amini P, Mirtavoos-Mahyari H, Motevaseli E, Shabeeb D, Musa AE, Cheki M, et al. Mechanisms for Radioprotection by Melatonin; Can it be Used as a Radiation Countermeasure? Curr Mol Pharmacol 2019; 12(1): 2-11.
  5. Zare MH, Astani A, Abdi-Goushbolagh N. The radiobiologic characterizations of normal lung cells treated with cerium oxide nanostructures as radioprotector against X-rays used in radiotherapy. J Isfahan Med Sch 2018; 36(481): 581-7. [In Persian].
  6. Dubousset J, Charpak G, Dorion I, Skalli W, Lavaste F, Deguise J, et al. A new 2D and 3D imaging approach to musculoskeletal physiology and pathology with low-dose radiation and the standing position: the EOS system. Bull Acad Natl Med 2005; 189(2): 287-97. [In French].
  7. Dubousset J, Charpak G, Skalli W, Deguise J. EOS: A new imaging system with low dose radiation in standing position for spine and bone and joint disorders. J Musculoskelet Res 2010; 13(1): 1-12.
  8. Folinais D, Thelen P, Delin C, Radier C, Catonne Y, Lazennec JY. Measuring femoral and rotational alignment: EOS system versus computed tomography. Orthop Traumatol Surg Res 2013; 99(5): 509-16.
  9. Dietrich TJ, Pfirrmann CW, Schwab A, Pankalla K, Buck FM. Comparison of radiation dose, workflow, patient comfort and financial break-even of standard digital radiography and a novel biplanar low-dose X-ray system for upright full-length lower limb and whole spine radiography. Skeletal Radiol 2013; 42(7): 959-67.
  10. Escott BG, Ravi B, Weathermon AC, Acharya J, Gordon CL, Babyn PS, et al. EOS low-dose radiography: a reliable and accurate upright assessment of lower-limb lengths. J Bone Joint Surg Am 2013; 95(23): e1831-e1837.
  11. Baunin C, Meyrignac O, Vial J, Sommet A, Moreno R, Labarre D, et al. Comparison between EOS imaging and CTscan for the femoral and tibial torsion measurements in children. Proceedings of the The European Congress of Radiology (ECR); 2014 Mar 6-10; Vienna, Austria.
  12. Damet J, Fournier P, Monnin P, Sans-Merce M, Ceroni D, Zand T, et al. Occupational and patient exposure as well as image quality for full spine examinations with the EOS imaging system. Med Phys 2014; 41(6): 063901.
  13. Newton PO, Khandwala Y, Bartley CE, Reighard FG, Bastrom TP, Yaszay B. New EOS imaging protocol allows a substantial reduction in radiation exposure for scoliosis patients. Spine Deform 2016; 4(2): 138-44.
  14. Ben AA, Aubry S, Ounalli L, Fayache MS, Delabrousse E, Petegnief Y. Comparative dose levels between CT-scanner and slot-scanning device (EOS system) in pregnant women pelvimetry. Phys Med 2017; 33: 77-86.