The use of ultrasound in comparison to radiography in magnetically controlled growth rod lengthening measurement

a prospective study

Wai Weng Yoon, Angela Christine Chang, Philippa Tyler, Sajid Butt, Sameer Raniga, Hilali Noordeen

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Purpose: This study investigated whether ultrasound (U/S) is an alternative to radiography when measuring magnetically controlled growth rod (MCGR) length in order to reduce radiation exposure. Distractible spinal growth rods are the gold standard when treating early-onset scoliosis (EOS). Methods: This was a prospective series. Patients were already undergoing EOS treatment using MCGRs. Forty-eight data points measured using radiography and U/S were compared. Each U/S data point was measured three times by three observers to assess intra- and inter-observer reliability. The radiation dose of the pre-lengthening and post-lengthening radiographs was recorded. Results: The average rod lengths were 1.322 cm with U/S and 1.329 cm with radiography. The ICC (radiography vs. U/S) was 0.992 (95 % confidence interval (CI) 0.976, 1.000). The inter- and intra-rater reliability of U/S had an ICC of 0.987 (95 % CI 0.966, 1.000) and 0.983 (95 % CI 0.956, 1.000), respectively. The mean total effective radiation dose of the pre-lengthening and post-lengthening PA spinal radiographs was 0.26 mSv with a mean attributable lifetime cancer risk of one in 39,686 per lengthening. Conclusion: U/S highly agrees with radiography when measuring MCGR length. It has a high inter- and intra-observer reliability and does not require radiation exposure. Although U/S allows accurate MCGR measurement and soft tissue assessment, patients will still need occasional radiographs to assess spine bony elements, overall spinal balance and scoliosis correction. Combining radiography and U/S allows patient monitoring and accurate MCGR measurement whilst decreasing patients’ radiation exposure.

Original languageEnglish
Pages (from-to)1422-1426
Number of pages5
JournalEuropean Spine Journal
Volume24
Issue number7
DOIs
Publication statusPublished - Sep 26 2015

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Radiography
Prospective Studies
Scoliosis
Growth
Confidence Intervals
Radiation
Physiologic Monitoring
Spine
Radiation Exposure
Neoplasms

Keywords

  • Early-onset scoliosis
  • Magnetically controlled growth rods
  • Radiation dose
  • Radiography
  • Ultrasound

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

The use of ultrasound in comparison to radiography in magnetically controlled growth rod lengthening measurement : a prospective study. / Yoon, Wai Weng; Chang, Angela Christine; Tyler, Philippa; Butt, Sajid; Raniga, Sameer; Noordeen, Hilali.

In: European Spine Journal, Vol. 24, No. 7, 26.09.2015, p. 1422-1426.

Research output: Contribution to journalArticle

Yoon, Wai Weng ; Chang, Angela Christine ; Tyler, Philippa ; Butt, Sajid ; Raniga, Sameer ; Noordeen, Hilali. / The use of ultrasound in comparison to radiography in magnetically controlled growth rod lengthening measurement : a prospective study. In: European Spine Journal. 2015 ; Vol. 24, No. 7. pp. 1422-1426.
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abstract = "Purpose: This study investigated whether ultrasound (U/S) is an alternative to radiography when measuring magnetically controlled growth rod (MCGR) length in order to reduce radiation exposure. Distractible spinal growth rods are the gold standard when treating early-onset scoliosis (EOS). Methods: This was a prospective series. Patients were already undergoing EOS treatment using MCGRs. Forty-eight data points measured using radiography and U/S were compared. Each U/S data point was measured three times by three observers to assess intra- and inter-observer reliability. The radiation dose of the pre-lengthening and post-lengthening radiographs was recorded. Results: The average rod lengths were 1.322 cm with U/S and 1.329 cm with radiography. The ICC (radiography vs. U/S) was 0.992 (95 {\%} confidence interval (CI) 0.976, 1.000). The inter- and intra-rater reliability of U/S had an ICC of 0.987 (95 {\%} CI 0.966, 1.000) and 0.983 (95 {\%} CI 0.956, 1.000), respectively. The mean total effective radiation dose of the pre-lengthening and post-lengthening PA spinal radiographs was 0.26 mSv with a mean attributable lifetime cancer risk of one in 39,686 per lengthening. Conclusion: U/S highly agrees with radiography when measuring MCGR length. It has a high inter- and intra-observer reliability and does not require radiation exposure. Although U/S allows accurate MCGR measurement and soft tissue assessment, patients will still need occasional radiographs to assess spine bony elements, overall spinal balance and scoliosis correction. Combining radiography and U/S allows patient monitoring and accurate MCGR measurement whilst decreasing patients’ radiation exposure.",
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AB - Purpose: This study investigated whether ultrasound (U/S) is an alternative to radiography when measuring magnetically controlled growth rod (MCGR) length in order to reduce radiation exposure. Distractible spinal growth rods are the gold standard when treating early-onset scoliosis (EOS). Methods: This was a prospective series. Patients were already undergoing EOS treatment using MCGRs. Forty-eight data points measured using radiography and U/S were compared. Each U/S data point was measured three times by three observers to assess intra- and inter-observer reliability. The radiation dose of the pre-lengthening and post-lengthening radiographs was recorded. Results: The average rod lengths were 1.322 cm with U/S and 1.329 cm with radiography. The ICC (radiography vs. U/S) was 0.992 (95 % confidence interval (CI) 0.976, 1.000). The inter- and intra-rater reliability of U/S had an ICC of 0.987 (95 % CI 0.966, 1.000) and 0.983 (95 % CI 0.956, 1.000), respectively. The mean total effective radiation dose of the pre-lengthening and post-lengthening PA spinal radiographs was 0.26 mSv with a mean attributable lifetime cancer risk of one in 39,686 per lengthening. Conclusion: U/S highly agrees with radiography when measuring MCGR length. It has a high inter- and intra-observer reliability and does not require radiation exposure. Although U/S allows accurate MCGR measurement and soft tissue assessment, patients will still need occasional radiographs to assess spine bony elements, overall spinal balance and scoliosis correction. Combining radiography and U/S allows patient monitoring and accurate MCGR measurement whilst decreasing patients’ radiation exposure.

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