A Radiation-Free Alternative to Imaging Chest Wall Deformities
A handheld, lightweight scanner — similar to the barcode reader at a store checkout — that uses white light instead of dangerous ionizing radiation can safely and reliably capture the upper body anatomy of children with chest wall deformities, according to pediatric surgeons from Lurie Children’s.
The approach, Lurie Children’s surgeons believe, offers a more convenient, inexpensive and safer alternative to traditional CT scans to measure and monitor the degree and severity of chest deformities. It may also provide a cheaper imaging option for patients in economically disadvantaged regions of the world, where sophisticated technology is unavailable or prohibitively expensive for most families.
Preliminary findings from research conducted at Lurie Children’s show that the radiation-free scanner can accurately and reliably capture abnormal chest shape in detailed, 3-D format among children with sunken chest, or pectus excavatum.
Results of the pilot study — involving 53 patients and presented May 15 at the annual meeting of the American Pediatric Surgical Association — revealed that the white-light scanner accurately measures the severity of the condition, allowing clinicians to track changes in depth and volume over time as the child ages or as a result of surgery.
White-light scanning has been used in eye imaging for years, but the Lurie Children’s research team says this is — to their knowledge — the first time the technology has been adapted for visualizing chest malformations.
Children with chest-wall defects generally undergo repeated evaluations for their chest deformity to monitor how it changes over time as the child grows or following surgery. Many clinicians measure the chest depression with a ruler, an old-school technique that is not as precise as a CT scan, which provides excellent visualization but exposes patients to ionizing radiation.
“As physicians, our first obligation is to do no harm, so we sought a new way to reliably and accurately capture the architecture of the chest wall without the use of radiation,” says study lead investigator Marleta Reynolds, MD, surgeon-in-chief for Lurie Children’s and Professor of Surgery at the Northwestern University Feinberg School of Medicine.
In addition to minimizing or eliminating the need for X-rays and CT scans, the white-light scanner is a more cost-conscious alternative in regions where sophisticated imaging is either lacking or inaccessible. A white light scanner costs around $35,000, compared with CT scanners, which can cost as much $275,000.
Another benefit of the white-light scanner is its size — it weighs less than 2 pounds — and can fit easily in a small carry-on suitcase, rendering it easy for moving and transport.
“This is a creative new twist on existing technology,” says Fizan Abdullah, MD, PhD , division chief of Pediatric Surgery at Lurie Children’s, an international authority on chest-wall deformities and professor of Surgery at the Northwestern University Feinberg School of Medicine. “It underscores the notion that even technology that’s been around for years can be harnessed in novel ways to make the practice of pediatric surgery simpler, cheaper and safer.”
The white-light scanning protocol is available to Lurie Children’s patients with chest defects as part of an ongoing clinical trial, although patient families can choose to receive traditional imaging instead.
Bryan Malas, MHPE, was co-investigator on the study.