title: Evaluation of the diagnostic performance of tomosynthesis in fractures of the wrist.
abstract: OBJECTIVE
  The purpose of our study was to define the diagnostic value of tomosynthesis compared with standard radiography and CT in wrist injuries.
  
  
  METHODS
  One hundred consecutive patients with acute wrist trauma were investigated with standard radiography, tomosynthesis, and CT. Reference results were those obtained with CT; follow-up monitoring of the patients; and, in some cases, MRI (n=13). Three readers interpreted the findings independently, each using a PACS workstation, and categorized the cases into four groups: fracture of the radius, fracture of the scaphoid, fracture of another bone, and absence of fracture.
  
  
  RESULTS
  Fifty-seven percent of the patients had a fracture. The interobserver kappa value varied between 0.54 and 0.59 for standard radiography, between 0.66 and 0.69 for tomosynthesis, and between 0.84 and 0.89 for CT. The sensitivity of standard radiography varied between 61% and 80% and specificity between 65% and 83%. The sensitivity of tomosynthesis ranged between 77% and 87%, and specificity between 76% and 82%. Ranges of sensitivity and specificity for CT were 93-95%, and 86-95%, respectively.
  
  
  CONCLUSIONS
  The diagnostic value of tomosynthesis is superior to that of standard radiography but inferior to that of CT.
authors.affiliation: Service d'Imagerie Guilloz, CHU Nancy, 29 Ave du maréchal de Lattre de Tassigny, CO n 34, Nancy 54035, France. ma.ottenin@orange.fr
authors.forename: Marie-Alexia
authors.initials: MA
authors.lastname: Ottenin
authors.forename: Adrien
authors.initials: A
authors.lastname: Jacquot
authors.forename: Olivier
authors.initials: O
authors.lastname: Grospretre
authors.forename: Alain
authors.initials: A
authors.lastname: Noël
authors.forename: Sophie
authors.initials: S
authors.lastname: Lecocq
authors.forename: Matthias
authors.initials: M
authors.lastname: Louis
authors.forename: Alain
authors.initials: A
authors.lastname: Blum
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011873:Radiology Information Systems; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014954:Wrist Injuries / Q000000981:diagnostic imaging*