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The variability of CT scan protocols for total hip arthroplasty: a call for harmonisation

Ramesh, Angelika; Di Laura, Anna; Henckel, Johann; Hart, Alister; (2023) The variability of CT scan protocols for total hip arthroplasty: a call for harmonisation. EFORT Open Reviews , 8 (11) pp. 809-817. 10.1530/EOR-22-0141. Green open access

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Abstract

CT is the principal imaging modality used for the pre-operative 3D planning and assessment of total hip arthroplasty (THA). The image quality offered by CT has a radiation penalty to the patient. Higher than necessary radiation exposure is of particular concern when imaging young patients and women of childbearing age, due to the greater risk of radiation-induced cancer in this group. A harmonised low-dose CT protocol is needed, evidenced by the huge variability in the 17 protocols reviewed. The majority of the protocols were incomplete, leading to uncertainty among radiographers when performing the scans. Only three protocols (20%) were optimised for both 'field of view' and image acquisition parameters. 10 protocols (60%) were optimised for 'field of view' only. These protocols included imaging of the relevant landmarks in the bony pelvis in addition to the knees - the reference for femoral anteversion. CT parameters, including the scanner kilovoltage (kV), milliamperage-time product (mAs) and slice thickness, must be optimised with a 'field of view' that includes the relevant bony landmarks. The recommended kV and mAs values were very wide ranging from 100 to 150 and from 100 to 250, respectively. The large variability that exists amongst the CT protocols illustrates the need for a more consistent low-dose CT protocol for the planning of THA. This must provide an optimal balance between image quality and radiation dose to the patient. Current CT scanners do not allow for measurements of functional pelvic orientation and additional upright imaging modalities are needed to augment them.

Type: Article
Title: The variability of CT scan protocols for total hip arthroplasty: a call for harmonisation
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1530/EOR-22-0141
Publisher version: https://doi.org/10.1530/EOR-22-0141
Language: English
Additional information: Open Access. This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. https://creativecommons.org/licenses/by-nc/4.0/
Keywords: computed tomography, hip arthroplasty, low dose, primary hip reconstruction, primary hip replacement, protocol
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Mechanical Engineering
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Ortho and MSK Science
URI: https://discovery.ucl.ac.uk/id/eprint/10181364
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