European Spine Journal

, Volume 27, Issue 5, pp 1082–1088 | Cite as

Dose, image quality and spine modeling assessment of biplanar EOS micro-dose radiographs for the follow-up of in-brace adolescent idiopathic scoliosis patients

  • Baptiste Morel
  • Sonia Moueddeb
  • Eleonore Blondiaux
  • Stephen Richard
  • Manon Bachy
  • Raphael Vialle
  • Hubert Ducou Le Pointe
Original Article



The aim of this study was to compare the radiation dose, image quality and 3D spine parameter measurements of EOS low-dose and micro-dose protocols for in-brace adolescent idiopathic scoliosis (AIS) patients.


We prospectively included 25 consecutive patients (20 females, 5 males) followed for AIS and undergoing brace treatment. The mean age was 12 years (SD 2 years, range 8–15 years). For each patient, in-brace biplanar EOS radiographs were acquired in a standing position using both the conventional low-dose and micro-dose protocols. Dose area product (DAP) was systematically recorded. Diagnostic image quality was qualitatively assessed by two radiologists for visibility of anatomical structures. The reliability of 3D spine modeling between two operators was quantitatively evaluated for the most clinically relevant 3D radiological parameters using intraclass correlation coefficient (ICC).


The mean DAP for the posteroanterior and lateral acquisitions was 300 ± 134 and 433 ± 181 mGy cm2 for the low-dose radiographs, and 41 ± 19 and 81 ± 39 mGy cm2 for micro-dose radiographs. Image quality was lower with the micro-dose protocol. The agreement was “good” to “very good” for all measured clinical parameters when comparing the low-dose and micro-dose protocols (ICC > 0.73).


The micro-dose protocol substantially reduced the delivered dose (by a factor of 5–7 compared to the low-dose protocol) in braced children with AIS. Although image quality was reduced, the micro-dose protocol proved to be adapted to radiological follow-up, with adequate image quality and reliable clinical measurements.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.


Adolescent idiopathic scoliosis EOS imaging system Biplanar radiographs Pediatric radiology 3D measurements 



No funding was secured for this study.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to disclose. The authors have no financial relationships relevant to this article to disclose.

Ethical statement

The local institutional review board approved this single center, non-interventional, prospective study.

Supplementary material

586_2018_5464_MOESM1_ESM.pptx (672 kb)
Supplementary material 1 (PPTX 673 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Radiology DepartmentClocheville Hospital, CHRU ToursToursFrance
  2. 2.Radiology DepartmentArmand Trousseau Hospital, AHHP ParisParisFrance
  3. 3.Department of Pediatric Imaging, Armand Trousseau HospitalPierre et Marie Curie-Paris UniversityParisFrance
  4. 4.Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTechParisFrance
  5. 5.The MAMUTH Hospital, University Department for Innovative Therapies in Musculoskeletal Diseases, Armand Trousseau HospitalParisFrance
  6. 6.Department of Pediatric RadiologyClocheville HospitalToursFrance

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