Keywords:
Musculoskeletal bone, CT-Quantitative, Audit and standards, Trauma
Authors:
S. Chaudhary, W. Y. Lim, L. Kruse, L. Emanuele, K. Gormly
DOI:
10.26044/ranzcr2022/R-0153
Conclusion
Our study looked at the implemenation of a DECT scanning protocol for all patients presenting with back pain at certain sites.
Our major questions were
- is it accurate?
- is it useful?
- who is it useful for?
Our data showed DECT has a high concordance with CT and subsequent imaging in detecting acute BME, comparable with the published data.
DECT was particularly useful in confirming old fractures, highlighting subtle fractures and suggesting new fractures and an explanation for acute pain.
It was useful in both the ED and GP setting. ED referrals were more likely to have a background of trauma, where BME can suggest acute fractures or highlight subtle fractures. In GP referrals for non-traumatic presentations, the absence of BME was particularly useful for confirming old fractures.
There were technical issues reported with the new technology and a learning curve for Radiologists. The confidence of Radiologists in calling "normal" scans increased with the more scans they read. We suggest teaching sessions and a case review library would be beneficial for radiologists, prior to wider implementation of reporting BME maps in clinical practice.