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00152232-200910003-00172AbstractSpine: Affiliated Society Meeting AbstractsSpine: Affiliated Society Meeting Abstracts© 2009 Lippincott Williams & Wilkins, Inc.10September 2009 p 176–177The Feasibility of Radiation-Free Diagnostic Monitoring in Adolescent Idiopathic Scoliosis using a Novel, Upright Positional MRI ProtocolE-Poster #31Electronic Poster AbstractsAuerbach, Joshua D. MD (Washington University School of Medicine); Lonner, Baron S. MD; Dean, Laura E. BA; Goldstein, Yael PA-CIntroduction: The concerns over the oncologic potential of cumulative doses of ionizing radiation in children and adolescents being monitored in AIS has led to the search for radiation-free diagnostic imaging modalities, including MRI. We hypothesize that a novel, upright positional MRI protocol can produce reliable spinal curvature images compared with traditional Xray, and may serve as a radiation-free alternative to traditional diagnostic monitoring for curve progression in AIS.Methods: Twenty consecutive patients (13F, 7M, average age 13.7yrs, range: 11–17yrs) with a diagnosis of AIS seen by a single surgeon were enrolled. Average major curve magnitude was 30.6°(range: 10–69°). Subjects underwent traditional plain radiographic scoliosis imaging (36″ cassettes), followed within 1 week by upright MRI using a standardized protocol. Complete MRI data acquisition was performed in <7minutes using a steady-state gradient echo 3D pulse sequence (TE=5.608, TR=14.720, Flip angle=30 deg). The two volumes were stitched together to facilitate multi-planar reconstruction analysis. Two independent observers measured the major and minor Cobb angle magnitudes on each set of plain film and MRI images.Results: There was excellent inter-rater reliability between plain film radiography and upright MRI measurements for major Cobb angle (R=0.91) and very strong reliability for minor Cobb angles (R=0.81). Intra-rater reliability for both Xray and MRI measurements of major Cobb angles was excellent (R=0.96, 0.95, respectively). Intra-rater reliability for both Xray and MRI measurements of the minor Cobb angles was also excellent (R=0.96, 0.92, respectively).Conclusion: Our results show that upright positional MRI is capable of producing major and minor Cobb angle measurements that highly correlate with traditional plain film radiographic measurements, and may therefore be a radiation-free alternative/substitute for diagnostic screening in AIS.Significance: Radiation-free diagnostic screening for AIS can be performed safely, quickly (total data acquisition time: <7min), and with costs comparable to Xray imaging. We submit that upright, positional MRI may serve as an alternative/replacement for traditional ionizing imaging techniques.<strong xmlns:mrws="http://webservices.ovid.com/mrws/1.0">The Feasibility of Radiation-Free Diagnostic Monitoring in Adolescent Idiopathic Scoliosis using a Novel, Upright Positional MRI Protocol</strong>: <strong xmlns:mrws="http://webservices.ovid.com/mrws/1.0">E-Poster #31</strong>Auerbach Joshua D. MD (Washington University School of Medicine); Lonner, Baron S. MD; Dean, Laura E. BA; Goldstein, Yael PA-CElectronic Poster AbstractsElectronic Poster Abstracts10p 176-177