Journal Article

Comparison of Diagnostic Accuracy of Radiation Dose-Equivalent Radiography, Multidetector Computed Tomography and Cone Beam Computed Tomography for Fractures of Adult Cadaveric Wrists

Benndorf, Matthias, Langer, Mathias, Kotter, Elmar, Neubauer, Jakob, Zajonc, Horst, Fiebich, Martin, Lampert, Florian, Krauß, Tobias, Goerke, Sebastian M., Reidelbach, Carolin

2016

Overview

To compare the diagnostic accuracy of radiography, to radiography equivalent dose multidetector computed tomography (RED-MDCT) and to radiography equivalent dose cone beam computed tomography (RED-CBCT) for wrist fractures. As study subjects we obtained 10 cadaveric human hands from body donors. Distal radius, distal ulna and carpal bones (n = 100) were artificially fractured in random order in a controlled experimental setting. We performed radiation dose equivalent radiography (settings as in standard clinical care), RED-MDCT in a 320 row MDCT with single shot mode and RED-CBCT in a device dedicated to musculoskeletal imaging. Three raters independently evaluated the resulting images for fractures and the level of confidence for each finding. Gold standard was evaluated by consensus reading of a high-dose MDCT. Pooled sensitivity was higher in RED-MDCT with 0.89 and RED-MDCT with 0.81 compared to radiography with 0.54 (P = < .004). No significant differences were detected concerning the modalities' specificities (with values between P = .98). Raters' confidence was higher in RED-MDCT and RED-CBCT compared to radiography (P < .001). The diagnostic accuracy of RED-MDCT and RED-CBCT for wrist fractures proved to be similar and in some parts even higher compared to radiography. Readers are more confident in their reporting with the cross sectional modalities. Dose equivalent cross sectional computed tomography of the wrist could replace plain radiography for fracture diagnosis in the long run.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Accuracy / Adult / Biology and Life Sciences / Bones / Cadavers / Calibration / Carpal Bones - diagnostic imaging / CAT scans / Comparative analysis / Computation / Computed tomography / Cone-Beam Computed Tomography - methods / Cone-Beam Computed Tomography - standards / Consent / Diagnostic imaging / Diagnostic systems / Engineering and Technology / Equivalence / Fractures / Fractures (Injuries) / Fractures, Malunited - diagnostic imaging / Hand (anatomy) / Hand surgery / Humans / Medical diagnosis / Medical imaging / Medical imaging equipment / Medicine and Health Sciences / Multidetector Computed Tomography - methods / Multidetector Computed Tomography - standards / Physical sciences / Radiation / Radiation (Physics) / Radiation Dosage / Radiography / Radiography - methods / Radiography - standards / Radius Fractures - diagnostic imaging / Reproducibility of Results / Research and Analysis Methods / Sensitivity analysis / Sensitivity and Specificity / Simulation / Surgery / Trauma / Ulna / Ulna Fractures - diagnostic imaging / Wrist / Wrist - diagnostic imaging / Wrist Injuries - diagnostic imaging