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Skeletal Radiology
Published in: Skeletal Radiology 3/2015

01-03-2015 | Scientific Article

Quality-controlled dose reduction of full-leg radiography in patients with knee malalignment

Authors: Jost Karsten Kloth, Regina Neumann, Eva von Stillfried, Wolfram Stiller, Hans-Ulrich Kauczor, Volker Ewerbeck, Marc-André Weber

Published in: Skeletal Radiology | Issue 3/2015

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Abstract

Objective

Digital plain radiographs of the full leg are frequently performed examinations of children and young adults. Thus, the objective of this work was to reduce the radiation exposure dependent on specific indications, and to determine objective quality-control criteria to ensure accurate assessment.

Materials and methods

Institutional review board approval and informed consent of all participants were obtained. In this prospective, randomized controlled, blinded, two-armed single-center study, 288 evaluable patients underwent plain radiography of the full leg with standard and reduced doses. The evaluation of the plain radiographs was conducted using the following criteria: mechanical axis, leg length, and maturation of the epiphyseal plate. Two blinded radiologists evaluated these criteria using a score ranging from 1 (definitely assessable) to 4 (not assessable). If a single criterion had been evaluated with a score of 3 or more points or all criteria with 2 points, the radiograph was scored as “not assessable”. The study was designed as a non-inferiority trial.

Results

Eleven (3.8 %) examined X-rays were scored as not assessable. The rate of non-assessable radiographs with 33 % reduced dose was significantly not inferior to the rate of non-assessable radiographs with standard dose. The evaluation of the quality criteria was dose independent.

Conclusions

Full-leg plain radiography in patients with knee malalignment can be performed at 33 % reduced dose without loss of relevant diagnostic information.
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Metadata
Title
Quality-controlled dose reduction of full-leg radiography in patients with knee malalignment
Authors
Jost Karsten Kloth
Regina Neumann
Eva von Stillfried
Wolfram Stiller
Hans-Ulrich Kauczor
Volker Ewerbeck
Marc-André Weber
Publication date
01-03-2015
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 3/2015
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-014-2004-5

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