Upright Tomosynthesis of the Lumbar Spine.

This experimental study investigates the potential of lumbar spine tomosynthesis to offset the traditional limitations of radiographic and computed tomography imaging, that is, superimposition of anatomy and disregard of physiological load-bearing. A gantry-free twin robotic scanner was used to obtain lateral radiographs and tomosyntheses of the lumbar spine under weight-bearing conditions in eight body donors. Tomosynthesis protocols varied in terms of sweep angle (20 versus 40°), scan time (2.4 versus 4.8 seconds), and framerate (16 versus 30 fps). Image quality and vertebral endplate assessability were evaluated by five radiologists with 4-8 years of skeletal imaging experience. Aiming to identify potential diagnostic deterioration near the scan volume margins, readers additionally determined the craniocaudal extent of clinically acceptable image quality. Tomosynthesis scans effectuated a substantial dose reduction compared to standard radiographs (3.8 ± 0.2 to 15.4 ± 0.8 dGy*cm Combining minimal radiation dose with superimposition-free visualization, 30 fps wide-angle tomosynthesis superseded radiography in all evaluated aspects. With superior diagnostic assessability despite significant dose reduction, load-bearing tomosynthesis appears promising as an alternative for first-line lumbar spine imaging in the future.

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Copyright © 2023 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

DECLARATION OF COMPETING INTEREST The authors declare the following financial interests/personal relationships, which may be considered as potential competing interests: Jan-Peter Grunz reports financial support was provided by German Society of Musculoskeletal Radiology, the Interdisciplinary Center of Clinical Research Würzburg, and Siemens Healthineers. Andreas Kunz, Thorsten Bley, and Jan-Peter Grunz report a relationship with Siemens Healthineers that includes consulting or advisory and paid expert testimony. Three authors (Magdalena Herbst, Sophia Herold, and Thomas Weber) are Siemens employees involved in the development of the tomosynthesis scan mode.