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Evaluation of ultra-low dose CT in the diagnosis of pediatric-like fractures using an experimental animal study.

Moritz JD, Hoffmann B, Sehr D, Keil K, Eggerking J, Groth G, Caliebe A, Dischinger J, Heller M, Bolte H - Korean J Radiol (2012)

Bottom Line: A success rate of at least 95% was considered sufficient for diagnostics.All dose levels were adequate for the identification of the displacement.The lowest dose level sufficient for diagnostics was 120 kVp, 11 mAs, and pitch 1.5, with a CTDIvol of 10% of a standard dose and an effective dose three times as large as that of X-rays.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Radiology, University Hospital Schleswig-Holstein, Kiel, Germany. joerg.d.moritz@rad.uni-kiel.de

ABSTRACT

Objective: The aim of this prospective study was to evaluate the performance of ultra-low dose CT for the diagnosis of pediatric-like fractures and ascertain the lowest dose level sufficient for diagnostics.

Materials and methods: Fifty-one bones of young pig cadavers were artificially fractured and subsequently examined by using a 64 multi-detector CT with 36 various dose levels down to a dose comparable with that of X-rays. Two pediatric radiologists analysed the CT scans according to the presence or absence of a fracture, determination of the fracture type and the displacement as well as the diagnostic certainty. For each dose protocol, a success rate for the correct determination of the above-mentioned CT analyses was calculated. A success rate of at least 95% was considered sufficient for diagnostics.

Results: All but the lowest dose levels were sufficient to identify the fracture. Only the two lowest dose levels were insufficient to detect the fracture type. All dose levels were adequate for the identification of the displacement. The lowest dose level sufficient for diagnostics was 120 kVp, 11 mAs, and pitch 1.5, with a CTDIvol of 10% of a standard dose and an effective dose three times as large as that of X-rays.

Conclusion: Ultra-low dose CT provides the feasibility of a significant dose reduction, still allowing sufficient diagnostics of pediatric-like fractures.

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Related in: MedlinePlus

Comminuted fractures of second and third metacarpals with step and impression (black arrow).All dose levels were diagnostic-A. 120 kVp, 100 mAs, pitch 0.9. B. 120 kVp, 11 mAs, pitch 1.5. C. 80 kVp, 11 mAs, pitch 1.5.
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Figure 3: Comminuted fractures of second and third metacarpals with step and impression (black arrow).All dose levels were diagnostic-A. 120 kVp, 100 mAs, pitch 0.9. B. 120 kVp, 11 mAs, pitch 1.5. C. 80 kVp, 11 mAs, pitch 1.5.

Mentions: The results of all dose levels achieved rates of success of 95% or higher in this criterion (Table 5) (Fig. 3). All wrongly described fracture displacements (n = 38) concerned the small tubular bones of the paws. In 15% (n = 6) of cases, one or more components of displacement in complex fractures were not recognized. The most frequently missed type of displacement was an impression.


Evaluation of ultra-low dose CT in the diagnosis of pediatric-like fractures using an experimental animal study.

Moritz JD, Hoffmann B, Sehr D, Keil K, Eggerking J, Groth G, Caliebe A, Dischinger J, Heller M, Bolte H - Korean J Radiol (2012)

Comminuted fractures of second and third metacarpals with step and impression (black arrow).All dose levels were diagnostic-A. 120 kVp, 100 mAs, pitch 0.9. B. 120 kVp, 11 mAs, pitch 1.5. C. 80 kVp, 11 mAs, pitch 1.5.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3303899&req=5

Figure 3: Comminuted fractures of second and third metacarpals with step and impression (black arrow).All dose levels were diagnostic-A. 120 kVp, 100 mAs, pitch 0.9. B. 120 kVp, 11 mAs, pitch 1.5. C. 80 kVp, 11 mAs, pitch 1.5.
Mentions: The results of all dose levels achieved rates of success of 95% or higher in this criterion (Table 5) (Fig. 3). All wrongly described fracture displacements (n = 38) concerned the small tubular bones of the paws. In 15% (n = 6) of cases, one or more components of displacement in complex fractures were not recognized. The most frequently missed type of displacement was an impression.

Bottom Line: A success rate of at least 95% was considered sufficient for diagnostics.All dose levels were adequate for the identification of the displacement.The lowest dose level sufficient for diagnostics was 120 kVp, 11 mAs, and pitch 1.5, with a CTDIvol of 10% of a standard dose and an effective dose three times as large as that of X-rays.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Radiology, University Hospital Schleswig-Holstein, Kiel, Germany. joerg.d.moritz@rad.uni-kiel.de

ABSTRACT

Objective: The aim of this prospective study was to evaluate the performance of ultra-low dose CT for the diagnosis of pediatric-like fractures and ascertain the lowest dose level sufficient for diagnostics.

Materials and methods: Fifty-one bones of young pig cadavers were artificially fractured and subsequently examined by using a 64 multi-detector CT with 36 various dose levels down to a dose comparable with that of X-rays. Two pediatric radiologists analysed the CT scans according to the presence or absence of a fracture, determination of the fracture type and the displacement as well as the diagnostic certainty. For each dose protocol, a success rate for the correct determination of the above-mentioned CT analyses was calculated. A success rate of at least 95% was considered sufficient for diagnostics.

Results: All but the lowest dose levels were sufficient to identify the fracture. Only the two lowest dose levels were insufficient to detect the fracture type. All dose levels were adequate for the identification of the displacement. The lowest dose level sufficient for diagnostics was 120 kVp, 11 mAs, and pitch 1.5, with a CTDIvol of 10% of a standard dose and an effective dose three times as large as that of X-rays.

Conclusion: Ultra-low dose CT provides the feasibility of a significant dose reduction, still allowing sufficient diagnostics of pediatric-like fractures.

Show MeSH
Related in: MedlinePlus