Abstract

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. To determine the detection rate of low-dose radiation CT and standard-dose radiation CT for fractures, in patients with suspected fractures. Systematic review of comparative studies on diagnostic accuracy within the evidence-based health program at a federal university in São Paulo (SP), Brazil. 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. 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. CT with low-dose radiation presented detection rates similar to those of CT with standard-dose radiation, regardless of the bones evaluated. CRD42019148491 at the PROSPERO database.

Highlights

  • Ionizing radiation such as X-rays is a singular form of energy that surmounts the binding energy of electrons that orbit atoms and molecules.[1]

  • Studies selected The search for this systematic review yielded 468 studies using the following medical subject headings (MeSH) terms: fractures, bone; radiation dosage; tomography, X-ray computed

  • There were no studies in which low-dose Computed tomography (CT) and standard-dose CT were performed on the same patient

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Summary

Introduction

Ionizing radiation such as X-rays is a singular form of energy that surmounts the binding energy of electrons that orbit atoms and molecules.[1] In biological material exposed to X-rays, the most common consequential scenario is that this creates hydroxyl radicals from interactions between X-rays and water molecules. These radicals, in turn, interact with deoxyribonucleic acid (DNA) to cause breakage of bonds or damage to the base.[1] mutations, chromosomal translocations and fusions between genes can occur, which in some cases may lead to cancer.[1].

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