Original Article

Pediatric Radiology

, Volume 43, Issue 10, pp 1303-1308

Radiation dose reduction in pediatric CT-guided musculoskeletal procedures

  • Anand S. PatelAffiliated withDepartment of Radiology and Biomedical Imaging, University of California, San Francisco, UCSF Benioff Children’s Hospital
  • , Bruno SoaresAffiliated withDepartment of Radiology and Biomedical Imaging, University of California, San Francisco, UCSF Benioff Children’s Hospital
  • , Jesse CourtierAffiliated withDepartment of Radiology and Biomedical Imaging, University of California, San Francisco, UCSF Benioff Children’s Hospital
  • , John D. MacKenzieAffiliated withDepartment of Radiology and Biomedical Imaging, University of California, San Francisco, UCSF Benioff Children’s Hospital Email author 

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Abstract

Background

Computed-tomography-guided interventions are attractive for tissue sampling of pediatric bone lesions; however, it comes with exposure to ionizing radiation, inherent to CT and magnified by multiple passes during needle localization.

Objective

We evaluate a method of CT-guided bone biopsy that minimizes ionizing radiation exposure by lowering CT scanner tube current (mAs) and voltage (kVp) during each localization scan.

Materials and methods

We retrospectively reviewed all CT-guided bone biopsies (n = 13) over a 1-year period in 12 children. Three blinded readers identified the needle tip on the reduced-dose CT images (mAs = 50, kVp = 80) during the final localization scan at biopsy and rated the image quality as high, moderate or low.

Results

The image quality of the reduced-dose scans during biopsy was rated as either high or moderate, with needle tip visualized in 12 out of 13 biopsies. Twelve of 13 biopsies also returned sufficient sample for a pathological diagnosis. The average savings in exposure using the dose-reduction technique was 87%.

Conclusion

Our results suggest that a low mAs and kVp strategy for needle localization during CT-guided bone biopsy yields a large dose reduction and produces acceptable image quality without sacrificing yield for biopsy diagnosis.

Keywords

Radiation dose CT-guided intervention Musculoskeletal procedure Image Gently Children