• La Radiologia medica · Sep 2017

    Ultra-low-dose periradicular infiltration of the lumbar spine: spot scanning and its potential for further dose reduction by replacing helical planning CT.

    • Fabian Henry Jürgen Elsholtz, Lars-Arne Schaafs, Christoph Erxleben, Bernd Hamm, and Stefan Markus Niehues.
    • Klinik und Hochschulambulanz für Radiologie, Charité- Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany. fabian.elsholtz@charite.de.
    • Radiol Med. 2017 Sep 1; 122 (9): 705-712.

    PurposeComputed tomography (CT)-guided periradicular infiltration has become an accepted procedure for treating radiculopathy-associated low back pain. The purpose of this study is to compare spot scanning and segmental helical planning CT in terms of dose reduction.Materials And MethodsEighty-five patients underwent CT-guided single-site lumbar periradicular therapy. Prior imaging was not available for planning. Sixty-three patients were examined with a new dedicated spot scanning technique (group I), and twenty-two patients underwent conventional segmental planning CT examinations with helical image acquisition serving as controls (group II). Examinations were reviewed retrospectively for dose-length product (DLP) and number of acquisitions required for intervention. Pain reduction accomplished with the intervention was recorded for quality assurance.ResultsMedian DLP was 0.80 mGy cm for spot scanning versus 6.50 mGy cm for segmental planning CT. Thus, the contribution of the planning scan to the total interventional dose decreased from 73 to 25%. As a result, the total interventional dose was reduced significantly from a median DLP of 8.90 mGy cm to 3.20 mGy cm (-64%). Acquisitions required during the intervention had a median DLP of 2.40 mGy cm for group I and 2.35 mGy cm for group II, showing no significant difference. Median pain reduction in both groups was two points on the numeric rating scale.ConclusionDedicated spot scanning for planning reduced the total median effective dose of the intervention by more than 64% without increasing the number of images required during the interventional procedure. Significant pain reduction was achieved with both approaches. Spot scanning is recommended for dose reduction.

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