Purpose or Case Report: EOS^TM is a biplanar radiographic imaging system that can simultaneously acquire whole-body frontal and lateral standing radiographs with moving x-ray tubes and detectors. EOS has been shown to reduce radiation exposure and study time in comparison to standard digital radiography. While it has primarily found utility in evaluation of scoliosis, there has been limited study of EOS in performing pediatric skeletal surveys, which can be time-consuming and challenging given the age of the patient and the large number of images required. This study evaluates how implementing EOS in combination with digital radiography (DR) can reduce the number of images acquired and improve patient/family experience.
Methods & Materials: 66 pediatric patients underwent genetic or oncologic skeletal surveys with EOS combined with DR. The total number of images acquired for study completion were recorded for these patients and compared to a control group of 36 patients whose skeletal surveys were completed only with DR. Parents of children who underwent the combined EOS/DR study were asked to fill out a survey which included assessments of 1) estimated time of the total study 2) ease of the study on the patient, and 3) likelihood of preferring EOS to be used for any future studies on a scale from 1 to 5.
Results: The total number of images required for study completion was significantly lower (p<0.001) with the use of EOS in combination with DR (9.8 ± 1.3) when compared with DR only (17.8 ± 2.4). Among survey respondents, 100% of the parents felt that the skeletal survey performed in conjunction with EOS was easy on their child. The vast majority of the parents attributed this to the minimization of time required to complete the total study, with 97% estimating that the total study time with EOS took 15 minutes or less. All survey respondents rated the likelihood of requesting future skeletal surveys to be performed with EOS at least a 4 out of 5 with 89% rating 5 out of 5.
Conclusions: In its use for pediatric skeletal surveys, the ability to perform biplanar whole body radiography with EOS shows promise in improving workflow by significantly reducing the number of images required for the study and thus minimizing the time and radiation exposure required to complete the study. Given the ease and comfort with which an otherwise time-intensive study can be performed, it has also been met by a strong positive response by parents who have shown preference for EOS over only standard digital radiography.