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Emphasizing the Diagnostic Value of Digital Tomosynthesis in Detecting Hip Fractures
Our institution recently implemented the use of digital tomosynthesis (DTS) to workup emergency room patients with suspected hip fractures after initial negative or indeterminate radiographs. Our purpose is to evaluate the diagnostic accuracy of DTS for hip fracture detection. We performed a retrosp...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Grapho Publications, LLC
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7442093/ https://www.ncbi.nlm.nih.gov/pubmed/32879901 http://dx.doi.org/10.18383/j.tom.2020.00031 |
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author | Ozimok, Cory Koff, David Parasu, Naveen |
author_facet | Ozimok, Cory Koff, David Parasu, Naveen |
author_sort | Ozimok, Cory |
collection | PubMed |
description | Our institution recently implemented the use of digital tomosynthesis (DTS) to workup emergency room patients with suspected hip fractures after initial negative or indeterminate radiographs. Our purpose is to evaluate the diagnostic accuracy of DTS for hip fracture detection. We performed a retrospective review of all DTS studies over a 17-month period (July 2017 to November 2018). The results of the radiographs and DTS were recorded as either positive or negative for fracture based on the radiology report. Our reference standard for a fracture was either confirmation on subsequent CT or MRI from the same visit or documentation of clinical findings supportive of a fracture in the patient’s electronic medical record. For patients with negative DTS who did not undergo subsequent cross-sectional imaging, a missed fracture was excluded if they did not return within 30 days with a confirmed fracture. Among 91 patients, there were 34 confirmed fractures—sites including, 7 femoral necks, 10 pubic rami, and 7 greater trochanters. DTS was positive for fracture in 29 patients; 28 of these fractures were true positives, 6 confirmed on cross-sectional imaging, and 22 confirmed clinically. One false positive was observed in a patient with no clinical evidence of a fracture. Six fractures were not detected by tomosynthesis but confirmed on CT/MRI. The sensitivity and specificity of DTS are 82% and 98%, respectively, compared to that of radiographs alone at 47% and 96%, respectively. DTS is a promising adjunct to radiographs for hip fracture detection in an emergency department. |
format | Online Article Text |
id | pubmed-7442093 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Grapho Publications, LLC |
record_format | MEDLINE/PubMed |
spelling | pubmed-74420932020-09-01 Emphasizing the Diagnostic Value of Digital Tomosynthesis in Detecting Hip Fractures Ozimok, Cory Koff, David Parasu, Naveen Tomography Research Article Our institution recently implemented the use of digital tomosynthesis (DTS) to workup emergency room patients with suspected hip fractures after initial negative or indeterminate radiographs. Our purpose is to evaluate the diagnostic accuracy of DTS for hip fracture detection. We performed a retrospective review of all DTS studies over a 17-month period (July 2017 to November 2018). The results of the radiographs and DTS were recorded as either positive or negative for fracture based on the radiology report. Our reference standard for a fracture was either confirmation on subsequent CT or MRI from the same visit or documentation of clinical findings supportive of a fracture in the patient’s electronic medical record. For patients with negative DTS who did not undergo subsequent cross-sectional imaging, a missed fracture was excluded if they did not return within 30 days with a confirmed fracture. Among 91 patients, there were 34 confirmed fractures—sites including, 7 femoral necks, 10 pubic rami, and 7 greater trochanters. DTS was positive for fracture in 29 patients; 28 of these fractures were true positives, 6 confirmed on cross-sectional imaging, and 22 confirmed clinically. One false positive was observed in a patient with no clinical evidence of a fracture. Six fractures were not detected by tomosynthesis but confirmed on CT/MRI. The sensitivity and specificity of DTS are 82% and 98%, respectively, compared to that of radiographs alone at 47% and 96%, respectively. DTS is a promising adjunct to radiographs for hip fracture detection in an emergency department. Grapho Publications, LLC 2020-09 /pmc/articles/PMC7442093/ /pubmed/32879901 http://dx.doi.org/10.18383/j.tom.2020.00031 Text en © 2020 The Authors. Published by Grapho Publications, LLC http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Research Article Ozimok, Cory Koff, David Parasu, Naveen Emphasizing the Diagnostic Value of Digital Tomosynthesis in Detecting Hip Fractures |
title | Emphasizing the Diagnostic Value of Digital Tomosynthesis in Detecting Hip Fractures |
title_full | Emphasizing the Diagnostic Value of Digital Tomosynthesis in Detecting Hip Fractures |
title_fullStr | Emphasizing the Diagnostic Value of Digital Tomosynthesis in Detecting Hip Fractures |
title_full_unstemmed | Emphasizing the Diagnostic Value of Digital Tomosynthesis in Detecting Hip Fractures |
title_short | Emphasizing the Diagnostic Value of Digital Tomosynthesis in Detecting Hip Fractures |
title_sort | emphasizing the diagnostic value of digital tomosynthesis in detecting hip fractures |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7442093/ https://www.ncbi.nlm.nih.gov/pubmed/32879901 http://dx.doi.org/10.18383/j.tom.2020.00031 |
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