Pediatric Radiology

, Volume 43, Issue 10, pp 1303–1308 | Cite as

Radiation dose reduction in pediatric CT-guided musculoskeletal procedures

  • Anand S. Patel
  • Bruno Soares
  • Jesse Courtier
  • John D. MacKenzie
Original Article



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.


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.


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%.


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.


Radiation dose CT-guided intervention Musculoskeletal procedure Image Gently Children 


Conflicts of interest



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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Anand S. Patel
    • 1
  • Bruno Soares
    • 1
  • Jesse Courtier
    • 1
  • John D. MacKenzie
    • 1
  1. 1.Department of Radiology and Biomedical Imaging, University of California, San FranciscoUCSF Benioff Children’s HospitalSan FranciscoUSA

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