title: Dual Energy CT - a Novel Technique for Diagnostic Testing of Fragility Fractures of the Pelvis.
abstract: BackgroundThe incidence of fragility fractures of the pelvis is increasing. Established methods to diagnose this condition include X-rays, computed tomography (CT) and magnetic resonance imaging (MRI). Dual energy CT (DECT) is a modern technology for the imaging of bone oedema/bruises and has been used in injuries of the extremities and spine. It is unclear whether this technique can also be used in fragility fractures of the pelvis. The aim of this study was to perform a literature research and survey of the "AG Becken III" members of the German Society of Trauma Surgery (DGU) on the usefulness of DECT in fractures of the pelvis.Material and MethodsA PubMed-based literature search on DECT comprised the key words "Dual Energy CT", "Pelvis/Pelvic", "Insufficiency" and "Fractures" and their combinations. Thirty-two publications were reviewed completely (full text). Finally, 15 articles were chosen and included in the current study. The survey of the members of the "AG Becken III" was based on a questionnaire and aimed to determine the popularity and potential benefits of DECT in comparison to established diagnostic options.ResultsNo studies on the use of DECT in fragility fractures of the pelvis were identified; the few articles found referred to fractures of the extremities and spine. The response rate to the questionnaire was 25/83 (30.1 %). The participants had a mean personal experience of 8.4 years/151.6 interventions in pelvic surgery. Although some respondents had heard of DECT, this technique - if available - was only used in other indications. However, the potential benefit of DECT was recognised, especially in the acute diagnostic testing of fragility fractures. There is limited consensus on the optimal diagnostic test (CT vs. MRI) of pelvic fractures.ConclusionAlthough DECT is already established for other indications and is regarded as a promising method by all respondents of the "AG Becken III", DECT is not yet routinely used for diagnostic testing of fragility fractures of the pelvis. Potential advantages of DECT include its greater sensitivity than CT in detecting bone oedema with equal radiation exposure. Unlike MRI, it is available 24 hours/7 days.
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, German Armed Forces Hospital Ulm.
authors.forename: Carsten
authors.initials: C
authors.lastname: Hackenbroch
authors.affiliation: Department of Trauma Surgery and Orthopedics, Reconstructive and Septic Surgery, Sports Traumatology, German Armed Forces Hospital Ulm.
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Riesner
authors.affiliation: Department of Trauma Surgery and Orthopedics, Reconstructive and Septic Surgery, Sports Traumatology, German Armed Forces Hospital Ulm.
authors.forename: Patricia
authors.initials: P
authors.lastname: Lang
authors.affiliation: Department of Trauma and Reconstruction Surgery, Tübingen University Hospital.
authors.forename: Fabian
authors.initials: F
authors.lastname: Stuby
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, German Armed Forces Hospital Ulm.
authors.forename: Burkhardt
authors.initials: B
authors.lastname: Danz
authors.affiliation: Department of Trauma Surgery and Orthopedics, Reconstructive and Septic Surgery, Sports Traumatology, German Armed Forces Hospital Ulm.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Friemert
authors.affiliation: Department of Trauma Surgery and Orthopedics, Reconstructive and Septic Surgery, Sports Traumatology, German Armed Forces Hospital Ulm.
authors.forename: Hans-Georg
authors.initials: HG
authors.lastname: Palm
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D016330:Frail Elderly / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D010384:Pelvic Bones / Q000000981:diagnostic imaging*; D010818:Practice Patterns, Physicians'; D011856:Radiographic Image Enhancement / Q000379:methods; D015900:Radiography, Dual-Energy Scanned Projection / Q000379:methods / Q000706:statistics & numerical data*; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000706:statistics & numerical data*; D014600:Utilization Review