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EOS Micro-dose Protocol: First Full-spine Radiation Dose Measurements in Anthropomorphic Phantoms and Comparisons with EOS Standard-dose and Conventional Digital Radiology

Pedersen, Peter Heide, MD; Petersen, Asger Greval, MSc, MPE; Østgaard, Svend Erik, MD, PhD; Tvedebrink, Torben, PhD; Eiskjær, Søren P., MD

doi: 10.1097/BRS.0000000000002696

Study Design. A comparative study of radiation dose measured in anthropomorphic phantoms.

Objectives. The aim of this study was to first report the first organ dose and effective dose measurements in anthropomorphic phantoms using the new EOS imaging micro-dose protocol in full-spine examinations, and to compare these measurements of radiation dose to measurements in the EOS standard-dose protocol and conventional digital radiology (CR).

Summary of Background Data. Few studies evaluating organ dose and effective dose for the EOS low-dose scanner exist, and mainly for the standard-dose protocol. To the best of our knowledge, no studies of effective dose based on anthropomorphic phantom measurements exist for the new micro-dose protocol.

Methods. Two anthropomorphic phantoms, representing a 5-year-old (pediatric) and a 15-year-old (adolescent). The phantoms were exposed to EOS micro-dose and standard-dose protocols during full-spine imaging. Additionally, CR in scoliosis settings was performed. For all modalities, organ doses were measured and effective doses were calculated using thermoluminescent dosimeters.

Results. We found a 17-fold reduction (94%) of effective dose in micro-dose protocol compared with our CR system in the adolescent phantom. Micro-dose versus standard-dose protocol, showed a 6-fold reduction (83%), and for standard-dose versus our CR system a 2.8-fold reduction (64%) reduction of effective dose was observed.

For the pediatric phantom, a 5-fold reduction (81%) of effective dose in micro-dose protocol compared to our CR system was observed. Micro-dose versus standard-dose protocol, showed a seven-fold (86%) reduction. However, we observed an increase in absorbed dose of 38% when comparing the EOS standard-dose protocol with our CR system.

Conclusion. The EOS imaging micro-dose option exposes patients to lower radiation doses than any currently available modality for full-spine examination. Expected reduction of dose was established for the adolescent phantom when comparing CR and standard-dose protocol. However, no reduction of effective dose with EOS standard-dose protocol compared to our reference CR system was observed in the pediatric phantom.

Level of Evidence: N/A

Department of Orthopedic Surgery, Aalborg Universitetshospital, Aalborg, Denmark

Region Nordjylland, Røntgenfysik, Denmark

Department of Mathematical Sciences, Aalborg University, Aalborg, Denmark.

Address correspondence and reprint requests to Peter Heide Pedersen, MD, Ortopædkirurgisk Afdeling, Aalborg Universitetshospital, Hobrovej 18–22, 9000 Aalborg, Denmark; E-mail:

Received 27 October, 2017

Revised 7 March, 2018

Accepted 10 April, 2018

The device(s)/drug(s) is/are FDA-approved or approved by corresponding national agency for this indication.

No funds were received in support of this work.

No relevant financial activities outside the submitted work.

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