Impact of introducing extremity cone-beam CT in an emergency radiology department: A population-based study - 26/03/21
, Vincent Morel a, Julien Dartus b, c, Sammy Badr a, Xavier Demondion a, b, Anne Cotten a, b
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Abstract |
Background |
Musculoskeletal cone-beam CT (CBCT) recently appeared on the market, with image quality comparable to that of high-resolution CT. It was previously implemented mainly in craniofacial surgery and in orthopedic limb surgery for weight-bearing imaging, but without large-scale assessment in emergency settings. We therefore conducted a retrospective comparative study in an emergency radiology department: 1) to assess whether introduction of CBCT dedicated to extremity traumatology reduced radiation dose delivered to the patient undergoing cross-sectional imaging, 2) to assess whether it increased turnover, and 3) to study the feasibility and practical consequences.
Study hypothesis Introducing CBCT dedicated to traumatology in an emergency radiology department reduces radiation dose related to cross-sectional imaging in extremity trauma.
Patients and methods |
Two periods were distinguished: in May-November 2016, the only cross-sectional imaging available in our emergency radiology department was multi-detector CT (MDCT); in May-November 2017, both MDCT and CBCT were available. Thus, the population in period 1 (n=165) had undergone only MDCT extremity imaging, while patients in period 2 underwent either CBCT (n=139) or MDCT (n=85). Study parameters notably included dose-length product (DLP) and length of patient stay in the radiology department (turnover).
Results |
Mean DLP was significantly reduced with the introduction of CBCT: 210.3±133.6 mGy.cm (range, 20–595) in period 1, versus 138.4±92.7 mGy.cm (range, 32–623) in period 2 (p<0.0001). Taking both periods together, mean DLP was 50.7% lower with CBCT (n=139) than MDCT (n=249): respectively, 101.6±14.9 mGy.cm (range, 50.6–126.9) versus 206.5±131.8 mGy.cm (range, 20–623) (p<0.0001). Turnover accelerated with the introduction of CBCT, with mean stay of 84.9minutes in period 1 versus 72.1minutes in period 2 (p=0.011). In period 2, turnover was 23.6% faster with CBCT than MDCT: respectively, 64.9minutes versus 85.0minutes (p=0.0004).
Discussion |
Introducing CBCT dedicated to the extremities in an emergency radiology department was feasible. It reduced overall radiation dose and accelerated turnover.
Level of Evidence |
III; comparative case-control study.
Le texte complet de cet article est disponible en PDF.Keywords : Cone-beam Computed Tomography, Multidetector Computed Tomography, Bone fractures, Radiology, Emergency department
Plan
Vol 107 - N° 2
Article 102834- avril 2021 Retour au numéro
Article précédent
- Deep learning for the radiographic diagnosis of proximal femur fractures: Limitations and programming issues
- Sylvain Guy, Christophe Jacquet, Damien Tsenkoff, Jean-Noël Argenson, Matthieu Ollivier
- EOS stereographic assessment of femoral shaft malunion after intramedullary nailing. A prospective series of 48 patients at 9 months’ follow-up
- Benoît Orfeuvre, Jérôme Tonetti, Gaël Kerschbaumer, Renaud Barthelemy, Alexandre Moreau-Gaudry, Mehdi Boudissa
Bienvenue sur EM-consulte, la référence des professionnels de santé.