Comparison of Cone-Beam Computed Tomography and Multislice Computed Tomography in the Assessment of Extremity Fractures

Objectives The aims of this study were to evaluate the agreement between cone-beam computed tomography (CBCT) and multislice computed tomography for the characterization of extremity fractures and to compare image quality, radiation dose, and patient tolerance. Methods Thirty-six patients with suspected fracture affecting distal extremities or who required preoperative fracture assessment were enrolled prospectively. Each patient underwent CBCT and multislice computed tomography the same day. Both examinations were evaluated independently twice by 2 trained radiologists using the Müller AO classification for fracture characterization. Results Cohen κ coefficient for agreement between the imaging techniques was almost perfect for fracture characterization, κ = 0.94 [95% confidence interval, 0.91–0.98]. There was substantial to almost perfect agreement for secondary findings. Cone-beam computed tomography was well tolerated and significantly less irradiant and had better subjective image. Conclusions An excellent agreement between both imaging techniques was found. This confirms the ability of CBCT to assess fractures and its potential in the management of patients with distal limb trauma. Received for publication September 24, 2018; accepted November 27, 2018. Correspondence to: Jean-Baptiste Pialat, MD, PhD, Service de Radiologie, Centre Hospitalier Lyon-Sud, 165 Chemin du Grand Revoyet, 69310 Pierre-Bénite, France (e-mail: Jean-baptiste.pialat@chu-lyon.fr). Research collaborative agreement was made between Hospices Civils de Lyon and SiTech Company for the provision of the Newtom5G CBCT scanner during the time of this study. The authors declare no conflict of interest. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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