A systematic procedure to optimise dose and image quality for the measurement of inter-vertebral angles from lateral spinal projections using Cobb and superimposition methods

Al Qaroot, B; Hogg, P; Twiste, M; Howard, D

Abstract

BACKGROUND: Patients with vertebral column deformations are exposed to high risks associated with ionising radiation exposure. Risks are further increased due to the serial X-ray images that are needed to measure and asses their spinal deformation using Cobb or superimposition methods. Therefore, optimising such X-ray practice, via reducing dose whilst maintaining image quality, is a necessity.

OBJECTIVES: With a specific focus on lateral thoraco-lumbar images for Cobb and superimposition measurements, this paper outlines a systematic procedure to the optimisation of X-ray practice.

METHODS: Optimisation was conducted based on suitable image quality from minimal dose. Image quality was appraised using a visual-analogue-rating-scale, and Monte-Carlo modelling was used for dose estimation. The optimised X-ray practice was identified by imaging healthy normal-weight male adult living human volunteers.

RESULTS: The optimised practice consisted of: anode towards the head, broad focus, no OID or grid, 80 kVp, 32 mAs and 130 cm SID.

CONCLUSION: Images of suitable quality for laterally assessing spinal conditions using Cobb or superimposition measurements were produced from an effective dose of 0.05 mSv, which is 83% less than the average effective dose used in the UK for lateral thoracic/lumbar exposures. This optimisation procedure can be adopted and use for optimisation of other radiographic techniques.

KEYWORDS: Cobb method; Optimisation of X-ray imaging; exposure dose reduction; image quality preservation; lateral thoraco-lumbar imaging; superimposition method

Citation

Al Qaroot, B., Hogg, P., Twiste, M., & Howard, D. (2014). A systematic procedure to optimise dose and image quality for the measurement of inter-vertebral angles from lateral spinal projections using Cobb and superimposition methods. Journal of X-Ray Science and Technology, 22(5), 613-625. https://doi.org/10.3233/XST-140449

• Journal Article Type: Article
• Acceptance Date: May 20, 2014
• Publication Date: Jan 1, 2014
• Deposit Date: Oct 14, 2014
• Publicly Available Date: Apr 5, 2016
• Journal: Journal of X-Ray Science and Technology
• Print ISSN: 0895-3996
• Electronic ISSN: 1095-9114
• Publisher: IOS Press
• Peer Reviewed: Peer Reviewed
• Volume: 22
• Issue: 5
• Pages: 613-625
• DOI: https://doi.org/10.3233/XST-140449
• Publisher URL: http://dx.doi.org/10.3233/XST-140449
• Related Public URLs: http://www.iospress.nl/journal/journal-of-x-ray-science-and-technology/