Computed tomography (CT) scans remain the most common imaging tools for diagnosing various medical conditions, however, some concerns remain about radiation exposure, particularly among children and young adults.
Researchers at New York University (NYU) Langone Medical Center have now discovered how to perform CT scans for joint fractures with just one-fourteenth the amount of normal CT radiation. This amount keeps the image quality high, while allowing surgeons to properly diagnose any issues.
"We have taken a frequently used and necessary imaging test and made it safer," lead study author Sanjit R. Konda, M.D., assistant professor of orthopaedic surgery at NYU Langone and director of orthopaedic trauma at Jamaica Hospital Medical Center, said. "Providing patients with a CT scan with 14-times less radiation could have significant implications from a public health and safety standpoint."
CT scans are helpful in diagnosing certain medical conditions, ranging from internal bleeding to broken bones, cancers and even signs of heart disease. However, previous research shows that radiation is linked to an increased risk of cancer. Of course, the risk remains relatively low, but close to 600,000 head and abdominal CT scans are annually performed on children under 15, and medical providers hope to rule out any unnecessary CT scans whenever possible.
During this recent study, researchers developed a protocol known as REDUCTION (Reduced Effective Dose Using Computed Tomography In Orthopaedic Injury) to examine CT scans involving orthopaedic injuries. Health officials usually use these scans to diagnose injuries around a joint, particularly a fracture involving the joint's surface.
At first, the researchers just used the protocol to examine air around the knee joint where infections can easily take place. Then, they used it to reduce the amount of radiation for traumatic joint fractures by examining ultra-low dose CT scans from 50 patients who showed clinical symptoms of joint fractures between Aug. 2014 and March 2015. These scans were then compared to a sample of participants with similar fracture injuries and similar age range who received a standard CT scan.
Findings showed that even with the low-dose CT scans, researchers achieved 98 percent accuracy in diagnosing a patient with a fracture and 89 percent specificity in diagnosing a patient without a fracture via the ultra-low dose CT scans. The accuracy was also similar to that seen when using conventional CT scans.
"The ability to perform ultra-low dose radiation CT scans without compromising image quality demonstrates the comprehensive capabilities of this protocol," senior study author Kenneth A. Egol, M.D., professor of orthopaedic surgery and chief of the division of orthopaedic trauma surgery at NYU Langone, said. "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."
The research is being presented today at the 2016 American Academy of Orthopedic Surgeons (AAOS) Annual Meeting.
