Low-Dose Hip CT Reduces Radiation by 90%

To determine if low-dose computed tomography (CT) protocols would make a difference in minimizing radiation in hip preservation surgery, a multicenter team of researchers conducted a retrospective cohort study of 59 patients, 41 of whom received a low-dose CT and 18 received the traditional dose of CT radiation.

The research team studied only patients who’d been treated with hip arthroscopy, for surgical hip dislocation, or with periacetabular osteotomy procedures at their institution between 2016 and 2017.

Their work, “Low-Dose Computed Tomography Reduces Radiation Exposure by 90% Compared With Traditional Computed Tomography Among Patients Undergoing Hip-Preservation Surgery,” appears in the April 12, 2019 edition of Arthroscopy.

Co-author Jeffrey Nepple, M.D., with the Department of Orthopaedic Surgery at Washington University in St. Louis explained to OTW his reasons for conducting the study: “Computed tomography (CT) is increasingly used in surgical planning for hip preservation surgery and is particularly useful for evaluation of acetabular coverage, relative to normative standards.”

“However, the radiation associated with CT has always been a concern. In other areas, low dose CT protocols have been shown to minimize radiation, but little attention has been paid to this in hip preservation.”

“We found that allowing the scanner to minimize the radiation tended to increase the radiation, compared to a standardized simple protocol. With a standardized low-dose CT protocol, we achieved a 90% reduction in the radiation associated with CT, while also removing the variability in dosing that is often technician, facility, or protocol specific.”

“Surgeons utilizing CT in the preoperative planning of hip preservation surgery should utilize low-dose CT protocols to minimize radiation. It is important particularly when establishing these protocols to monitor the actual radiation exposure for each patient undergoing CT.”

“Low-dose CT for hip preservation surgery can be consistently obtained with a radiation exposure similar to 3-4 AP pelvis (or frog or Dunn lateral) radiographs, or 1 cross-table lateral radiograph.”