Paediatric pelvic imaging: optimisation of dose and technique using digital grid-controlled pulsed fluoroscopy

Area of Science:

• Radiology
• Paediatric Imaging
• Radiation Dose Reduction

Background:

• Paediatric pelvic radiographs revealed issues with gonad shielding and technique.
• Perthes disease and Developmental Hip Dysplasia (DDH) require regular pelvic radiography in children.

Purpose of the Study:

• To evaluate grid-controlled fluoroscopy (GCF) for optimizing gonad shield placement and reducing radiation dose.
• To compare frame grab and digital spot image (DSI) formats in paediatric pelvic radiography.

Main Methods:

• Conducted phantom and patient dose surveys comparing conventional and fluoroscopic techniques.
• Assessed image quality and radiation dose for frame grab and DSI.
• Performed retrospective evaluation of clinical acceptability.

Main Results:

• Fluoroscopic techniques reduced radiation by 67-83% compared to conventional radiography (P < 0.05).
• Frame grab technique yielded lower radiation doses than DSI (P < 0.05).
• No significant difference in clinical acceptability between DSI and frame grab images.

Conclusions:

• Fluoroscopy-acquired images are now standard due to lower dose and sufficient quality.
• Frame grab alone will be adopted for further dose savings, as it matches DSI's clinical usefulness.