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Meta-Analysis
. 2021 Jul-Aug;139(4):388-397.
doi: 10.1590/1516-3180.2020.0374.R3.1902021.

Computed tomography with low-dose radiation versus standard-dose radiation for diagnosing fractures: systematic review and meta-analysis

Márcio Luís Duarte  1 , Lucas Ribeiro Dos Santos  2 , Acary Souza Bulle Oliveira  3 , Wagner Iared  4 , Maria Stella Peccin  5
Affiliations
Meta-Analysis

Computed tomography with low-dose radiation versus standard-dose radiation for diagnosing fractures: systematic review and meta-analysis

Márcio Luís Duarte et al. Sao Paulo Med J. 2021 Jul-Aug.

Abstract

Background: Computed tomography (CT) accounts for 13% of all radiological examinations in the United States and 40-70% of the radiation that patients receive. Even with the advent of magnetic resonance imaging (MRI), CT continues to be the gold standard for diagnosing bone fractures. There is uncertainty as to whether CT with a low radiation dose has a fracture detection rate similar to that of standard-dose CT.

Objective: To determine the detection rate of low-dose radiation CT and standard-dose radiation CT for fractures, in patients with suspected fractures.

Design and setting: Systematic review of comparative studies on diagnostic accuracy within the evidence-based health program at a federal university in São Paulo (SP), Brazil.

Methods: We searched the electronic databases Cochrane Library, MEDLINE, EMBASE and LILACS up to June 29, 2020, for studies evaluating the detection rates of low-dose CT and standard-dose CT for diagnosing bone fractures. The Research Triangle Institute (RTI) item bank tool was used for methodological quality evaluation.

Results: The fracture detection rate according to the number of bones evaluated, using CT with low-dose radiation was 20.3%, while with standard-dose radiation it was 19.2%, and the difference between the methods was not significant. The fracture detection rate according to the number of patients, using CT with low-dose radiation was 56.0%, while with standard-dose radiation it was 58.7%, and this difference between the methods was not significant, either.

Conclusion: CT with low-dose radiation presented detection rates similar to those of CT with standard-dose radiation, regardless of the bones evaluated.

Registration number: CRD42019148491 at the PROSPERO database.

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Conflict of interest statement

Conflicts of interest: The authors declare that they did not have any conflict of interest

Figures

Figure 1
Figure 1. Summary of the study selection process.
Figure 2
Figure 2. Forest plot: comparison demonstrating that there was no significant difference between low-dose CT and standard-dose CT regarding the detection rate for bone fractures.
Figure 3
Figure 3. Forest plot: comparison demonstrating that there was no significant difference between low-dose CT and standard-dose CT regarding the detection rate for patients with fractures.
See this image and copyright information in PMC

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