title: [Comparison of conventional full spine radiographs and fluoroscopic scanning method in young patients with idiopathic scoliosis].
abstract: OBJECTIVE
  Evaluation of low-dose full spine radiographs using fluoroscopic images for the assessment of the Cobb angle measurement in patients with scoliosis.
  
  
  METHODS
  Twenty-one consecutive patients (aged 10 - 27 years, mean age 14 years) with a conventional full spine examination (film speed class 800) underwent a follow-up exam using digital pulsed fluoroscopy (Multi Diagnost 4, Philips Medical Systems, Eindhoven, The Netherlands). The mean follow-up was 9 months. During a synchronized scan with a C-arm speed of 4 cm/sec fluoroscopic images were stored with a pulsed frequency of 3 images per second. The single images were merged and reconstructed to one image with the software Easy Spine (Philips medical Systems, Eindhoven, The Netherlands). The corresponding dose-area product values (DAP) of both methods were compared. Three independent observers assessed Cobb angles and image quality for each technique.
  
  
  RESULTS
  The mean DAP values for conventional imaging was 94.9 cGy x cm (2) and for fluoroscopy 7.8 cGy x cm (2), respectively. A significant dose reduction of 91.8 % (CI 91 % to 95 %) was calculated. The average absolute angle difference between the observers was found to be 2.7 degrees for conventional imaging and 2.4 degrees for the fluoroscopic method. Interobserver standard deviation of 2.9 degrees was lower than the 5.3 degrees for conventional images. Image quality was better in the conventional images.
  
  
  CONCLUSIONS
  Using the scanning method, we could achieve a mean reduction of the radiation dose of 92 %, while the accuracy of the Cobb angle measurements was comparable for both techniques despite of reduced image quality of digital fluoroscopy.
authors: Abteilung für Radiologische Diagnostik, Universitätsklinikum Tübingen. juergen.schaefer@med.uni-tuebingen.de
authors: J
authors: J
authors: Schaefer
authors: T
authors: T
authors: Kluba
authors: T
authors: T
authors: Niemeyer
authors: T
authors: T
authors: Hahnfeldt
authors: R
authors: R
authors: Vonthein
authors: R
authors: R
authors: Kottke
authors: K-F
authors: KF
authors: Kamm
authors: C
authors: C
authors: Claussen
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D011856:Radiographic Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D012600:Scoliosis / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D013131:Spine / Q000000981:diagnostic imaging*; D014962:X-Ray Film