Low-Dose Computed Tomography Reduces Radiation Exposure by 90% Compared With Traditional Computed Tomography Among Patients Undergoing Hip-Preservation Surgery.

Su, Alvin W; Hillen, Travis J; Eutsler, Eric P; Bedi, Asheesh; Ross, James R; Larson, Christopher M; Clohisy, John C; Nepple, Jeffrey J · Arthroscopy · 2019

retrospective_cohort · Level III

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Abstract

To compare the delivered radiation dose between a low-dose hip computed tomography (CT) scan protocol and traditional hip CT scan protocols (i.e., "traditional CT"). This was a retrospective comparative cohort study. Patients who underwent hip-preservation surgery (including arthroscopy, surgical hip dislocation, or periacetabular osteotomy procedures) at our institution between 2016 and 2017 were identified. Patients were excluded if they had a body mass index (BMI) greater than 35, they underwent previous surgery, or a radiation dose report was absent. The low-dose group included patients who underwent hip CT at our institution using a standardized protocol of 100 kV (peak), 100 milliampere-seconds (mAs), and a limited scanning field. The traditional CT group included patients who had hip CT scans performed at outside institutions. The total effective dose (E<sub>hip</sub>), effective dose per millimeter of body length scanned, patients' age, and patients' BMI were compared by univariate analysis. The correlation of E<sub>hip</sub> to BMI was assessed. The study included 41 consecutive patients in the low-dose group and 18 consecutive patients in the traditional CT group. Low-dose CT resulted in a 90% reduction in radiation exposure compared with traditional CT (E<sub>hip</sub>, 0.97 ± 0.28 mSv vs 9.68 ± 6.67 mSv; P < .0001). Age (28 ± 11 years vs 26 ± 10 years, P = .42), sex (83% female patients vs 76% female patients, P = .74), and BMI (24 ± 3 vs 24 ± 3, P = .75) were not different between the 2 groups. E<sub>hip</sub> had a poor but significant correlation to BMI in the low-dose CT group (R<sup>2</sup> = 0.14, slope = 0.03, P = .02) and did not correlate to BMI in the traditional CT group (R<sup>2</sup> = 0.13, P = .14). A low-dose hip CT protocol for the purpose of hip-preservation surgical planning resulted in a 90% reduction in radiation exposure compared with traditional CT. Level II, diagnostic study.

Medical subject headings

Anatomy