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Low Dose Computed Tomography for 3D Planning of Total Hip Arthroplasty: Evaluation of Radiation Exposure and Image Quality

Huppertz, Alexander MD*†; Lembcke, Alexander MD; Sariali, El-hadi MD; Durmus, Tahir MD; Schwenke, Carsten§; Hamm, Bernd MD; Sparmann, Martin MD; Baur, Alexander D. J. MD

Journal of Computer Assisted Tomography: September/October 2015 - Volume 39 - Issue 5 - p 649–656
doi: 10.1097/RCT.0000000000000271
Musculoskeletal Radiology

Objective The aim of the study was to compare radiation exposure and image quality between dedicated computed tomography (CT) protocols for preoperative total hip arthroplasty (THA) planning.

Methods Three protocols with automated tube current modulation using 64-slice (n = 177) and 128-slice CT scanners without (n = 129) and with automated tube voltage preselection (n = 84) were compared.

Results All 390 CTs were of sufficient quality for THA planning. Mean DLP was 235.0 mGy*cm (effective dose 2.8 mSv). Lowest radiation exposure (2.5 mSv) was seen with automated voltage preselection and the algorithm's selection was 100 kV (90.5% of patients) and 120 kV. Lowest image noise was seen in the highest dose group (3.1 mSv, 128-slice CT fixed tube voltage). A significant difference in cortical bone radiodensity was seen between 100 kV and 120 kV (P < 0.0001).

Conclusions Preoperative pelvic CT for THA planning is possible with very low radiation dose and reliable quality. Automated voltage preselection further decreases the effective dose by 18.2%.

From the *Department of Radiology, Klinikum Ernst von Bergmann, Potsdam; †Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany; ‡Department of Orthopaedic Surgery, Hôpital Pitié Salpétrière, Paris, France; §Scossis Statistical Consulting; and ∥Orthopaedic Surgery, Proendo, Berlin, Germany.

Received for publication March 12, 2015; accepted April 20, 2015.

Correspondence to: Alexander Huppertz, MD, Department of Radiology, Klinikum Ernst von Bergmann, Charlottenstraße 72, D-14467 Potsdam, Germany (e-mail:

A.H. has been a full time employee of Siemens AG until December 2014. His function has been the associate director of the Imaging Science Institute, a scientific cooperation between the Charité- Universitätsmedizin Berlin and Siemens Healthcare in form of a private-public partnership. C.S. is an external consultant for Siemens AG with regard to biostatistical topics. He gave statistical support in planning and reporting of this project and performed the statistical analysis on an honorary basis. E.S. and M.S. have received payment for lectures by Symbios Orthopédie SA. For the remaining authors, no potential conflicts of interest related to this manuscript were declared.

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.