- Article
- Open access
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- Geert J. Streekstra2,3,
- Johannes G. G. Dobbe2,3,
- Mario Maas2,4 &
- …
- Barend J. van Royen1,2
Scientific Reports (2026) Cite this article
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Abstract
Patient-specific guides improve pedicle screw placement in pediatric deformity surgery, but the preoperative CT entails radiation. Tin-filtered ultra-low-dose CT reduces dose, yet its effect on vertebral segmentation and pedicle screw planning remains unknown. This study therefore assesses geometric agreement between tin-filtered ultra-low-dose CT and standard-dose CT. Five ultra-low-dose and five standard-dose CT scans of one human cadaver were obtained. Vertebrae T2, L2 and S1 were segmented to quantify within- and between-protocol variability of pedicle morphometrics. For planning analysis, screws (T2-S1) were planned on the first standard-dose scan and transferred to the ultra-low-dose segmentations (fixed screw positions). Accuracy was evaluated using the Gertzbein-Robbins scale and screw-to-cortex distances. Pedicle morphometrics differed by ≤ 0.5 mm between protocols, with higher variability on ultra-low-dose CT (CV < 5% for both protocols). After transfer of planned screws from standard-dose to ultra-low-dose segmentations, all remained Gertzbein-Robbins grade A. Ultra-low-dose CT yielded larger screw-to-cortex clearances, with mean absolute differences of 0.14 mm to the medial cortex, 0.21 mm to the superior cortex, and 0.71 mm from screw tip to anterior cortex. Tin-filtered ultra-low-dose CT reduced radiation by > 75%, while preserving sub-millimeter agreement in pedicle morphometrics and screw-to-cortex clearances, suggesting minimal impact on the pedicle screw planning.
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The use of human cadaveric material was conducted in accordance with institutional procedures. The Biobank Research Ethics Committee (CTB, Amsterdam UMC, The Netherlands) approved release of the material (approval no. 2025.0836).
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Cool, J., Streekstra, G.J., Dobbe, J.G.G. et al. Geometric agreement in pedicle morphometrics and screw planning between tin-filtered ultra-low-dose CT and standard-dose CT: an exploratory cadaveric study. Sci Rep (2026). https://doi.org/10.1038/s41598-026-65392-w
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DOI: https://doi.org/10.1038/s41598-026-65392-w