Effective dose and breast dose reduction in paediatric scoliosis X-ray radiography by an optimal positioning

The purpose of this article is to recommend positioning to reduce the effective and breast-absorbed-doses in paediatric scoliosis radiography. Effective and breast-absorbed-doses were evaluated using Monte Carlo simulations. Head directed towards the anode (HTA) positioning rather than head directed towards the cathode (HTC) reduces the effective dose to 98 in anterior posterior (AP), 98 in left lateral (L LAT) and 96 in right lateral (R LAT) projections. HTC in posterior anterior (PA) projection contributes a smaller effective dose than HTA by 1 , but causes a breast-absorbed-dose excess (HTA/HTC breast dose ratios were 85 and 87 for 10- and 15-y- olds). With the preferential HTA positioning, R LAT projection reduced effective dose to 85 and 84 compared with L LAT, for 10 and 15 y olds. AP-HTA projection caused 183 and 181 larger effective doses than PA-HTA and breast-absorbed-dose excesses of 550 and 879 , for 10 and 15 y olds. When possible, use R LAT and PA projections to reduce effective dose; Of secondary importance, whenever possible, use HTA, with the exception that for 15 y olds, PA-HTC reduces the effective dose more than HTA (1 ) but causes a breast-absorbed-dose excess.