title: Use of a full-body digital X-ray imaging system in acute medical emergencies: a systematic review.
abstract: BACKGROUND
  To evaluate the available evidence for the clinical effectiveness and biohazard safety of a full-body digital X-ray imaging system (Lodox) in acute medical emergencies.
  
  
  METHODS
  Electronic databases (including PubMed, Embase and the Cochrane Library; up to January 2014) and reference lists of articles were searched. The quality of the included studies was determined, and a narrative assessment was undertaken.
  
  
  RESULTS
  A total of 256 articles were reviewed. Fifteen clinical studies and eight case series met the eligibility criteria. All 23 studies reporting use of a full-body X-ray imaging system in acute medical emergencies on Lodox. Based on figures in six studies comprising various evaluation methods, image quality of Lodox was mostly comparable to that of conventional X-rays and the radiation dose was considerably lower. Lodox demonstrated a sensitivity ranging from 62% to 73%, and a specificity ranging from 99% to 100% compared with CT for the evaluation of emergency patients with polytrauma, which is similar to that of conventional X-rays. Examination time using Lodox ranged from 3.5  to 13.9 min compared with 8 to 25.7 min using conventional X-rays. However, there was no evidence it significantly shortened resuscitation time or emergency department length of stay. Publication bias might have occurred; some published studies might have been influenced by conflicts of interest.
  
  
  CONCLUSIONS
  The Lodox machine is capable of rapidly scanning the entire body and offers an equivalent diagnostic assessment tool compared with conventional X-rays. It seems to have the potential to reduce cumulative radiation dosage for emergency patients compared with conventional X-rays. Application of Lodox might be helpful to reduce resource use and simplify care in lower-resourced areas.
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, School of Medicine & Institute of Emergency Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, School of Medicine & Institute of Emergency Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Li-Gang
authors.initials: LG
authors.lastname: Ye
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, School of Medicine & Institute of Emergency Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Jian-Bo
authors.initials: JB
authors.lastname: Ding
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, School of Medicine & Institute of Emergency Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Zhong-Jun
authors.initials: ZJ
authors.lastname: Zheng
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, School of Medicine & Institute of Emergency Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Mao
authors.initials: M
authors.lastname: Zhang
mesh_terms: D000208:Acute Disease; D004630:Emergencies; D006801:Humans; D011859:Radiography; D051598:Whole Body Imaging; D014947:Wounds and Injuries / Q000000981:diagnostic imaging*
keywords: Trauma