Reduced CT Dose Effective in Joint Fracture Detection

A new study claims that computerized tomography (CT) scans for joint fractures can be performed with one-fourteenth the amount of radiation, without compromising image quality.

Researchers at NYU Langone Medical Center (New York, NY, USA) and Jamaica Hospital Medical Center (JHMC; NY, USA) used the reduced computed tomography in orthopedic injury (REDUCTION) protocol to determine the lowest dose necessary for detecting traumatic joint fractures. To do so, 50 fracture patients with clinical symptoms received ultra-low dose (0.03 msV) radiation CT scans, which were compared to a sample of age-matched, similar fracture injuries where patients were evaluated with a standard CT scan dose (0.43 msV).

The results showed 98% sensitivity and 89% specificity with the ultra-low dose CT scans, a detection rate which is comparable to conventional CT-scans (98% sensitivity and 85% specificity), when occult fractures were removed from the equation. Image quality was rated moderate to near perfect by orthopedic surgeons. The study was presented at the American Academy of Orthopedic Surgeons (AAOS) specialty day, held during March 2016 in Orlando (FL, USA).

“We have taken a frequently used and necessary imaging test and made it safer,” said lead author and study presenter assistant professor of orthopedic surgery Sanjit Konda, MD, of NYU Langone, and director of orthopedic trauma at JHMC. “Providing patients with a CT scan with 14-times less radiation could have significant implications from a public health and safety standpoint.”

“The ability to perform ultra-low dose radiation CT scans without compromising image quality demonstrates the comprehensive capabilities of this protocol,” said senior author Professor Kenneth Egol, MD, chief of the division of orthopedic trauma surgery at NYU Langone. “Patients who undergo a traumatic injury or suspected fracture have enough to worry about. Our research makes radiation exposure among the least of their concerns.”

CT scans help diagnose medical conditions including broken bones, cancers, internal bleeding, or signs of heart disease. Yet, despite its prevalent use, medical societies and federal agencies have been increasingly trying to reduce the number of unnecessary scans due to radiation's link to an increased risk for cancer. While the overall risk is considered low, there is particular concern in performing CT scans on children.

Related Links:
NYU Langone Medical Center
Jamaica Hospital Medical Center