Radiation dose reduction in multidetector CT in fracture evaluation

Objective: To evaluate whether multidetector CT with low-dose radiation (low-dose CT) of joints can be useful when evaluating fractures. Methods: Our study included CT scans of 398 patients, 103 shoulder cases, 109 wrist cases, 98 pelvis cases and 88 ankle cases. There were 191 females and 207 males. The low-dose CTs were performed using identical voltage and parameters with the exception of decreased (half of standard dose) tube current. Low-dose and standard-dose images were compared with regards to objective image quality, subjective evaluation of image quality and diagnostic performance for the fractures. Results: There was no significant difference of image noise between standard-dose CT and low-dose CT in every joint (p > 0.05). Each mean value of subjective score did not show significant difference according to the dosage of the CT scan. There were no statistically significant differences in the sensitivity (96-100%), specificity (95.2-100%) or accuracy (97.9-100%) between standard-dose CT and low-dose CT (p values, 0.1336- 1.000). Conclusion: The evaluation of extremities for fractures using low-dose CT can reduce radiation exposure by about 50% compared with standard-dose CT without affecting image quality or diagnostic performance. Advances in knowledge: Low-dose CT of the extremities (shoulder, pelvis, ankle and wrist) can reduce radiation dose by about 50% compared with standard-dose CT and does not significantly affect image quality or diagnostic performance in fracture detection.