Department of Trauma and Orthopaedic Surgery, St George's University Hospital, London, UK.
Spine Deform. 2023 Jul;11(4):847-851. doi: 10.1007/s43390-023-00653-6. Epub 2023 Mar 22.
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.
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.
We identified 206 children (mean age 14.4) who met the criteria of having both scans. Dose area products (dGycm) 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).
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.
III.
儿童在脊柱侧弯的检查和治疗阶段会受到大量的辐射剂量。EOS 是一种新的低剂量辐射扫描方式，也能获得高质量的图像。然而，由于成本较高，目前在英国不鼓励使用这种方法。我们旨在量化额外的辐射剂量和癌症风险。
我们回顾性地分析了在六个月内，所有接受过站立位全脊柱 X 线片和 EOS 扫描检查的儿童脊柱侧弯病例。我们比较了两种检查方法的辐射剂量，并估计了每例研究的额外平均终生癌症风险。
我们确定了 206 名符合条件的儿童（平均年龄 14.4 岁），他们都接受了这两种扫描。剂量面积乘积（dGycm）转换为估算有效剂量（mSv）。全脊柱 X 线片的总平均剂量为 0.68 mSv（PA 0.49+Lat 0.19），EOS 扫描的总平均剂量为 0.13 mSv（PA 0.08+Lat 0.04）（p<0.001）。对于男女两性，全脊柱 X 线片的额外终生癌症风险均比 EOS 高 5.4 倍（男性为 1/10727 比 1/5827，女性为 1/34483 比 1/6350）。
与 EOS 相比，全脊柱 X 线片会使男孩和女孩的癌症风险分别增加约 5.4 倍，女孩受影响最大。当考虑到儿童因额外的终生恶性肿瘤风险而需要重复成像时，这会产生重大影响。在我们看来，当需要全脊柱 X 射线检查时，EOS 双平面扫描是新的金标准。
III。
