Purpose
Tomosynthesis for evaluation of suspect occult hip fracture has previosly been evaluated in a master thesis from our institution [1].
The purpose of the current study was to retrospectively further explore the possible clinical utility of digital tomosynthesis in patients with occult hip fractures.
Methods and Materials
In a retrospective review all cases with tomosynthesis of the hip performed for suspect occult hip fracture were retrieved from the hospital picture and archiving communication system (PACS).
Seventy cases with suspect occult hip fracture and normal or equivocal pelvis and hip radiography were included,
on 49 women and 21 men.
Mean age was 81 years (range 51-98 years).
For tomosynthesis 60 low-dose projection images from tube angles from − 17.5° to +17.5° were used to reconstruct up to 60 coronal sectional images without overlap,...
Results
Interobserver agreements for tomosynthesis of suspect occult hip fractures for the three observer pairs were almost perfect with kappa values 0.95,
0.92,
and 0.90 for the three observer pairs. Intraobserver agreements for two of the observers were equally good.
Agreements for cervical hip fractures were slightly better than for trochanteric fractures.
In 57 patients with complete observer agreement and confirmation by follow-up,
tomosynthesis identified all nine pelvic fractures,
scored 10 cervical fractures correctly,
detected 12 trochanteric fractures correctly while one scored trochanteric fracture was negative...
Conclusion
Observer variation for tomosynthesis as measured by the kappa statistic was almost perfect to substantial with narrower confidence intervals and with less observer variation than previously presented for radiography [2].
As secondary imaging after hip trauma in the elderly,
MRI is usually the modality of choice [3,
4].
CT may also be used [5,
6] with reliable results.
As shown in the current study,
also tomosynthesis may assist in making the diagnosis of hip fracture or normal outcome,
or may help by strengthening the radiographic...
References
1.
Bazzi M (2009) Clinical utility of tomosynthesis in diagnosis of occult hip fractures.
A pilot study with appraisal of the VolumeRad technique.
Clinical utility of tomosynthesis in diagnosis of occult hip fractures.
A pilot study with appraisal of the VolumeRad technique.
Örebro University,
School of Health and Medical Sciences,
Örebro 1-14
2.
Collin D,
Dunker D,
Göthlin JH,
Geijer M (2011) Observer variation for radiography,
computed tomography,
and magnetic resonance imaging of occult hip fractures.
Acta Radiol 52:871-874
3.
Verbeeten KM,
Hermann KL,
Hasselqvist...
Personal Information
Mats Geijer,
M.D.,
Ph.D.
Center for Medical Imaging and Physiology,
Skåne University Hospital and Lund University,
Lund,
Sweden.
David Collin,
M.D.,
Department of Radiology,
Sahlgrenska University Hospital,
Mölndal,
Sweden
Jan H.
Göthlin,
M.D.,
Ph.D.,
Department of Radiology,
Sahlgrenska University Hospital,
Mölndal,
Sweden