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Effective dose and effective risk from post-SPECT imaging of the lumbar spine

Tootell, AK; McEntee, MF; Szczepura, K; Hogg, P

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Authors

AK Tootell

MF McEntee



Abstract

Purpose
Planar bone scans play an important role in the staging and monitoring of malignancy and metastases. Metastases in the lumbar spine are associated with significant morbidity, therefore accurate diagnosis is essential. Supplementary imaging after planar bone scans is often, required to characterise lesions, however, this is associated with additional radiation dose. This paper provides information on the comparative effective dose and effective risk from supplementary lumbar spine radiographs, low-dose CT (LDCT) and diagnostic CT (DCT).
Method
Organ dose was measured in a phantom using thermo-luminescent dosimeters. Effective dose and effective risk were calculated for radiographs, LDCT, and DCT imaging of the lumbar spine.
Results
Radiation dose was 0.56mSv for the antero-posterior and lateral lumbar spine radiographs, 0.80mSv for LDCT, and 3.78mSv for DCT. Additional imaging resulted in an increase in effective dose of 12.28%, 17.54% and 82.89%for radiographs, LDCT and DCT respectively. Risk of cancer induction decreased as age increased. The difference in risk between the modalities also decreased. Males had a statistically significant higher risk than female patients (p=0.023) attributed to the sensitive organs being closer to the exposed area.
Conclusion
Effective Dose for LDCT is comparable to radiographs of the lumbar spine. Due to the known benefits image fusion brings it is recommended that LDCT replace radiographs imaging for characterisation of lumbar spine lesions identified on planar bone scan. DCT is associated with significantly higher effective dose than LDCT. Effective risk is also higher and the difference is more marked in younger female patients.

Citation

Tootell, A., McEntee, M., Szczepura, K., & Hogg, P. (2016). Effective dose and effective risk from post-SPECT imaging of the lumbar spine. Journal of Medical Imaging and Radiation Sciences, 47(3), 267-275. https://doi.org/10.1016/j.jmir.2016.04.012

Journal Article Type Article
Acceptance Date Apr 25, 2016
Online Publication Date Jun 28, 2016
Publication Date Jun 28, 2016
Deposit Date Apr 26, 2016
Publicly Available Date Jun 28, 2017
Journal Journal of Medical Imaging and Radiation Sciences
Print ISSN 1939-8654
Electronic ISSN 1876-7982
Publisher Elsevier
Volume 47
Issue 3
Pages 267-275
DOI https://doi.org/10.1016/j.jmir.2016.04.012
Publisher URL http://dx.doi.org/10.1016/j.jmir.2016.04.012
Related Public URLs http://www.journals.elsevier.com/journal-of-medical-imaging-and-radiation-sciences/

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