Equivalent Dose and Risk of Exposure Induced Cancer Death of Different Organs due to Various Image Techniques of EOS Imaging System

A Whole-Spine Radiography Study to Reduce Patient Exposure Dose and Artifacts Using the EOS Imaging System

Whole-spine radiography can be accomplished through two methods: (1) segmented imaging employing X-ray tube angulation and detectors, or (2) the Euronext Paris Advanced Orthopedic Solutions (EOS) 2D Imaging system that can capture the entire spine in a single image using X-ray tubes and detectors oriented at a 90-degree angle. This study aimed to establish optimal EOS examination parameters based on patient morphotype and scan speed to reduce patient radiation exposure, repeat examinations, heat stress on equipment, and X-ray tube cooling time. X-ray exposure conditions involved adjustments of scan speed ranging from two to four steps, contingent upon the patient's morphotype ('S', small body; 'M', medium body; and 'L', large body. Patient dose measurements were conducted 20 times for each set of conditions. When transitioning from an 'S' to an 'M' morphotype at a constant scan speed, the entrance skin dose (ESD) exhibited an increase of approximately 41.25 ± 4.57%. A similar change from an 'M' to an 'L' morphotype resulted in an ESD increase of roughly 59.56 ± 24.00%. A transition from an 'S' to an 'L' morphotype at the same scan speed manifested an ESD elevation of approximately 124.21 ± 26.96%. This study underscores significant variations in radiation dose, ranging from 40% to 50%, when altering morphotype while maintaining a consistent scan speed.

Deep learning-based identification of spine growth potential on EOS radiographs

OBJECTIVES

To develop an automatic computer-based method that can help clinicians in assessing spine growth potential based on EOS radiographs.

METHODS

We developed a deep learning-based (DL) algorithm that can mimic the human judgment process to automatically determine spine growth potential and the Risser sign based on full-length spine EOS radiographs. A total of 3383 EOS cases were collected and used for the training and test of the algorithm. Subsequently, the completed DL algorithm underwent clinical validation on an additional 440 cases and was compared to the evaluations of four clinicians.

RESULTS

Regarding the Risser sign, the weighted kappa value of our DL algorithm was 0.933, while that of the four clinicians ranged from 0.909 to 0.930. In the assessment of spine growth potential, the kappa value of our DL algorithm was 0.944, while the kappa values of the four clinicians were 0.916, 0.934, 0.911, and 0.920, respectively. Furthermore, our DL algorithm obtained a slightly higher accuracy (0.973) and Youden index (0.952) compared to the best values achieved by the four clinicians. In addition, the speed of our DL algorithm was 15.2 ± 0.3 s/40 cases, much faster than the inference speeds of the clinicians, ranging from 177.2 ± 28.0 s/40 cases to 241.2 ± 64.1 s/40 cases.

CONCLUSIONS

Our algorithm demonstrated comparable or even better performance compared to clinicians in assessing spine growth potential. This stable, efficient, and convenient algorithm seems to be a promising approach to assist doctors in clinical practice and deserves further study.

CLINICAL RELEVANCE STATEMENT

This method has the ability to quickly ascertain the spine growth potential based on EOS radiographs, and it holds promise to provide assistance to busy doctors in certain clinical scenarios.

KEY POINTS

• In the clinic, there is no available computer-based method that can automatically assess spine growth potential. • We developed a deep learning-based method that could automatically ascertain spine growth potential. • Compared with the results of the clinicians, our algorithm got comparable results.

ASSESSMENT OF PCXMC MONTE CARLO SIMULATIONS IN SLOT-SCANNING-BASED EXAMINATIONS: COMPARISON WITH IN-PHANTOM THERMOLUMINESCENT DOSIMETRY

Slot-scanning technology is nowadays a valid solution for the follow-up of chronic musculoskeletal disorders on children and adolescent patients, but there is no commercial software designed for simulating this X-ray beam geometry. PC Program for X-ray Monte Carlo (PCXMC) is a widespread Monte Carlo software developed for dose computation in projection radiography. In this study, experimental measurements were performed to evaluate its applicability in examinations with a slit-beam device. Physical phantoms corresponding to an adult and a 5-y-old child with calibrated thermoluminescent dosemeters were used for experiments. Different simulation approaches were investigated. Differences between measured and calculated organ doses ranged from -95 to 67% and were statistically significant for almost all organs. For both patients, PCXMC underestimated the effective dose of about 25%. This study suggests that PCXMC is not suited for organ dose evaluation in examinations with slot-scanning devices. It is still a useful tool for effective dose estimation when a proper correction factor is applied.

A Study of Radiation Protection Standards Compliance in Hospital Radiographic Departments in Iran

Background

The X-ray is a critical diagnostic and therapeutic tool with harmful effects. The International Commission on Radiological Protection (ICRP) has some recommendations regarding applying radiation protection principles.

Objective

This study aimed to determine the standards of the typical radiation protection in radiographic departments of hospitals in Iran.

Material and Methods

In this cross-sectional descriptive study, the usual radiation protection standards in places, such as the physical environment of the control and waiting rooms, radiographic devices, the physical space of the darkroom, and shielding facilities, were investigated using a checklist in Iran. A total of 84 hospitals in 51 cities throughout Iran were randomly selected, and the checklists were distributed to the radiation protection officers. In hospitals with multiple radiography rooms, the radiation protection officers were asked to complete the checklist about the room with the highest workload as a baseline to evaluate their facilities. Finally, the authors reviewed all checklists.

Results

In radiology departments in control and waiting rooms, the mean of radiation protection was 71.9%. Pregnancy and radiation warning signs and labels were present in 96.1% of the parameters, while gonad shielding protocols were not presented.

Conclusion

The principles of observed radiation protection were unsatisfactory, and it is recommended that surveillance be conducted at frequent intervals.