Evaluating the Efficacy of Radiation-Free Imaging Techniques in the Diagnosis and Management of Scoliosis: A Systematic Review and Meta-Analysis

Introduction: This systematic review explores the efficacy of radiation-free imaging techniques in the diagnosis and management of scoliosis, emphasizing the need to reduce cumulative radiation exposure from traditional methods like X-ray and computed tomography (CT). With pediatric and adolescent patients requiring repeated imaging, there is increasing interest in alternatives like magnetic resonance imaging (MRI), ultrasound, and surface topography to minimize health risks associated with ionizing radiation.

Methods: A systematic search of peer-reviewed studies comparing radiation-free imaging techniques with conventional methods was conducted. Studies were included if they evaluated diagnostic accuracy, clinical utility, and the effectiveness of these methods in monitoring scoliosis progression or planning treatment. Python or R was used for statistical meta-analysis, calculating pooled effect sizes and heterogeneity to assess diagnostic accuracy across modalities. Sensitivity, specificity, and reduction in radiation exposure were key outcome measures.

Results: MRI and three-dimensional surface topography demonstrated diagnostic accuracy comparable to traditional X-ray in assessing spinal curvature and monitoring scoliosis progression. The meta-analysis showed that MRI had high sensitivity and specificity, especially when combined with other imaging modalities. Surface topography also proved valuable in routine follow-ups, significantly reducing the need for X-rays. However, limitations were identified in certain techniques, such as ultrasound, which lacked sufficient detail for precise osseous assessments critical in surgical planning.

Conclusion : Radiation-free imaging techniques offer promising alternatives for scoliosis diagnosis and management, particularly in reducing radiation exposure for young patients. While MRI and surface topography provide strong diagnostic performance, further research is needed to optimize their clinical application and overcome limitations in structural evaluation. These techniques, when integrated with current diagnostic protocols, could transform scoliosis management, improving patient safety without compromising diagnostic quality.