Université Paris-Saclay, CEA, List, Palaiseau, France.
EOS Imaging, Paris, France.
Med Phys. 2023 Feb;50(2):1162-1184. doi: 10.1002/mp.15954. Epub 2022 Sep 19.
EOSedge™ (EOS Imaging, Paris, France) is an X-ray imaging system using automatic exposure control (AEC) with tube current modulation, in order to optimize dose deposition in patients.
This study aims at characterizing EOSedge organ dose deposition in comparison to a digital radiography (DR) system and the previous EOS system (EOS-1st generation), in relation to their respective image quality levels.
Organ doses were measured in an anthropomorphic female adult phantom and a 5-year-old pediatric phantom using optically stimulated luminescence (OSL) dosimeters, which were carefully calibrated within the studied energy range. Organ doses were recorded on the EOSedge and the Fuji Visionary DRF (Fujifilm Medical Systems U.S.A., Inc, Lexington, MA). The resulting effective doses were compared to the EOS-1st-generation values present in the literature. Image quality assessment was carried out on end-user images. Quantitative image quality metrics were computed for all tested modalities on a quality assurance phantom. Qualitative assessment of EOSedge image quality was based on anthropomorphic phantom acquisitions against the EOS-1st-generation system, and on clinical images against the tested DR system.
For a full-spine exam, and on the female adult phantom (respectively, the pediatric phantom), an effective dose of 92 μSv (respectively, 32 μSv) was obtained on EOSedge, and 572 μSv (respectively, 179 μSv) on the DR system; these values were compared to effective dose values of 290 μSv (respectively, 200 μSv) from the literature on EOS-1st generation, leading to an effective dose reduction factor of 6 with respect to the DR system, and of 3-6 with respect to EOS-1st generation. EOSedge provides the best compromise between contrast-to-noise ratio (CNR) and dose, with more consistent CNR values than the other tested modalities, in a range of attenuation from 10 to 40 cm of poly(methyl methacrylate) (PMMA). Within this range, EOSedge is also comparable to DR for 10 and 20 cm of PMMA, and better than DR for 30 and 40 cm of PMMA, both in terms of spatial resolution and low-contrast detection. The anatomical landmarks of interest in the follow-up of spinal deformities can be detected in all tested modalities.
Results showed that EOSedge provides significant dose reduction factors for full spine imaging in both adults and children compared to the other tested modalities, without compromising image quality. We believe that this work could help raise awareness on the capabilities of modern X-ray systems, when equipped with appropriate AEC strategies, to perform ultra-low-dose, long-axis images.
EOSedge™（EOS 成像，巴黎，法国）是一种使用自动曝光控制（AEC）和管电流调制的 X 射线成像系统，旨在优化患者的剂量沉积。
本研究旨在比较 EOSedge 器官剂量沉积与数字射线照相系统（DR）和以前的 EOS 系统（EOS-第一代），并与各自的图像质量水平相关联。
使用光激励发光（OSL）剂量计在人体成年女性和 5 岁儿科患者模型中测量器官剂量，这些剂量计在研究的能量范围内经过仔细校准。在 EOSedge 和富士 Visionary DRF（富士胶片医疗系统美国公司，列克星敦，MA）上记录器官剂量。将所得有效剂量与文献中 EOS-第一代的值进行比较。对最终用户图像进行图像质量评估。在质量保证体模上计算所有测试模式的定量图像质量指标。基于与 EOS-第一代系统的人体成年患者模型以及与测试的 DR 系统的临床图像，对 EOSedge 图像质量进行定性评估。
对于全脊柱检查，在女性成年患者模型（儿科患者模型）中，EOSedge 获得的有效剂量为 92 μSv（32 μSv），DR 系统获得的有效剂量为 572 μSv（179 μSv）；与文献中 EOS-第一代的 290 μSv（200 μSv）相比，有效剂量降低了 6 倍，与 DR 系统相比，降低了 3-6 倍。EOSedge 在对比度噪声比（CNR）和剂量之间提供了最佳折衷，与其他测试模式相比，具有更一致的 CNR 值，衰减范围为 10 至 40 cm 的聚甲基丙烯酸甲酯（PMMA）。在此范围内，EOSedge 与 DR 相比，在 10 和 20 cm 的 PMMA 上具有可比性，在 30 和 40 cm 的 PMMA 上优于 DR，在空间分辨率和低对比度检测方面均具有优势。脊柱畸形随访中感兴趣的解剖学标志可以在所有测试模式中检测到。
结果表明，与其他测试模式相比，EOSedge 为成人和儿童的全脊柱成像提供了显著的剂量降低因子，而不会影响图像质量。我们相信，当配备适当的 AEC 策略时，这项工作可以帮助提高对现代 X 射线系统能力的认识，从而实现超低剂量的长轴图像。
