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Usefulness of the spectral shaping dual-source computed tomography imaging technique in posterior corrective fusion for adolescent idiopathic scoliosis

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Abstract

Purpose

Since childhood exposure to radiation has been demonstrated to increase cancer risk with increase in radiation dose, reduced radiation exposure during computed tomography (CT) evaluation is desired for adolescent idiopathic scoliosis (AIS). Therefore, this retrospective study aimed to investigate the radiation dose of dual-source CT using a spectral shaping technique and the accuracy of the thoracic pedicle screw (TPS) placement for posterior spinal fusion (PSF) in patients with AIS.

Methods

Fifty-nine female patients with thoracic AIS who underwent PSF using CT-guided TPSs were included and divided into two groups comprised of 23 patients who underwent dual-source CT (DSCT) with a tin filter (DSCT group) and 36 who underwent conventional multislice CT (MSCT group). We assessed the CT radiation dose using the CT dose index (CTDIvol), effective dose (ED), and accuracy of TPS insertion according to the established Neo’s classification.

Results

The DSCT and MSCT groups differed significantly (p < 0.001) in the mean CTDIvol (0.76 vs. 3.31 mGy, respectively) and ED (0.77 vs. 3.47 mSv, respectively). Although the correction rate of the main thoracic curve in the DSCT group was lower (65.7% vs. 71.2%) (p = 0.0126), the TPS accuracy (Grades 0–1) was similar in both groups (381 screws [88.8%] vs. 600 screws [88.4%], respectively) (p = 0.8133). No patient required replacement of malpositioned screws.

Conclusion

Spectral shaping DSCT with a tube-based tin filter allowed a 75% radiation dose reduction while achieving TPS insertion accuracy similar to procedures based on conventional CT without spectral shaping.

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Acknowledgements

We would like to thank Editage (www.editage.com) for the English language editing.

Funding

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Authors and Affiliations

  1. Division of Radiological Technology, Department of Technical Support, Niigata University Medical and Dental Hospital, Niigata, Japan

    Yoshiyuki Noto & Tatsuya Kuramoto

  2. Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi Dori, Chuo-Ku, Niigata, 951-8510, Japan

    Yuki Endo, Masayuki Ohashi & Kei Watanabe

  3. Department of Orthopedic Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minami-Uonuma City, Niigata, Japan

    Toru Hirano

  4. Department of Radiological Technology, Tohoku University Graduate School of Medicine, Miyagi, Japan

    Yoshiyuki Noto & Koichi Chida

Authors
  1. Yoshiyuki Noto
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Contributions

YN was involved in conceptualization, methodology, software, data curation, Writing—review & editing; YE helped in investigation; MO: resources; TH contributed to resources; TK was involved in project administration; KC helped in writing—review & editing, supervision; KW contributed to conceptualization, methodology, writing—original draft, visualization, funding acquisition.

Corresponding author

Correspondence to Kei Watanabe.

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None of the authors has any potential conflict of interest.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee (Approval Number: 2015–1385) and the 1964 Declaration of Helsinki and its later amendments.

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Informed consent was obtained from the patients or their guardians before the study’s participation began.

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Noto, Y., Endo, Y., Ohashi, M. et al. Usefulness of the spectral shaping dual-source computed tomography imaging technique in posterior corrective fusion for adolescent idiopathic scoliosis. Eur Spine J 33, 706–712 (2024). https://doi.org/10.1007/s00586-023-08006-7

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