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Radiostereometric analysis: comparison of radiation dose and precision in digital and computed radiography

  • Hip Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

Radiostereometric Analysis (RSA) is used to measure fixation of joint prosthesis. This study compared radiation dose and image quality of a digital radiography (DR) RSA system and a computed radiography (CR) RSA system in a clinical setting.

Methods

RSA recordings of 24 hips and shoulders were analyzed. We compared two systems: (1) Arcoma T0 with ST-VI image plates and Profect CR-IR 363 reader to (2) AdoraRSA with CXDI-70C wireless DR detectors in a clinical uniplanar RSA set-up with a ± 20 degrees tube angulation and 35 cm × 43 cm detectors. Effective dose was calculated using dedicated software. Image quality was evaluated using calibration errors as calculated by the RSA software.

Results

The mean dose for hips was 0.14 (SD 0.04) mSv in the CR system and 0.05 (SD 0.02) mSv in the DR system. The mean dose for shoulders was 0.16 (SD 0.07) mSv in the CR system and 0.09 (SD 0.03) mSv in the DR system. Radiation dose was 64% (p < 0.001) and 43% (p = 0.03) lower in the DR system compared with the CR system for hip and shoulder RSA, respectively. Image quality was better for the DR system with 60–80% less calibration errors compared to the CR system.

Conclusion

Owing to highly efficient detectors and added filtration at the x-ray tubes, the DR system considerably reduced radiation dose compared with the CR system without compromising image quality.

Based on the findings in this study, we recommend replacing CR RSA systems with DR RSA systems.

Registration

Patients were selected from clinical studies performed on the two systems and approved by the local ethics committee [20060165, M-20100112, M-20070082, M-20110224, and 20070258] and registered with ClinicalTrials.gov [NCT00408096, NCT01289834, NCT00913679, NCT02311179, and NCT00679120].

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Availability of data and materials

Due to GDPR and the sensitive nature of x-rays, sharing of raw data is not possible. However, we will try to accommodate any reasonable request for sharing anonymized data.

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Funding

The study was performed under the Innovation Fund Denmark Grant 69–2013-1 “Transforming radiological technology for assessment of implant fixation: from research tool to clinical application”. None of the authors report any conflicts of interest.

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Authors and Affiliations

  1. AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Palle Juul-Jensens, Boulevard 99, 8200, Aarhus N, Denmark

    Peter Bo Jørgensen, Rikke Margrethe Staghøj Mørup & Maiken Stilling

  2. Department of Radiology, Aarhus University Hospital, Aarhus, Denmark

    Nicolai Krag-Nielsen & Lars Lindgren

  3. Biomechanics and Imaging Group (BIG), Leiden University Medical Center, Leiden, The Netherlands

    Bart Kaptein

Authors
  1. Peter Bo Jørgensen
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  2. Nicolai Krag-Nielsen
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  3. Lars Lindgren
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  4. Rikke Margrethe Staghøj Mørup
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  5. Bart Kaptein
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  6. Maiken Stilling
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Contributions

PBJ, NKN, BK and MS designed and wrote the manuscript, and RMSM performed the image analyses. All contributed to the data interpretation and critical revision of the manuscript.

Corresponding author

Correspondence to Peter Bo Jørgensen.

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Competing interests

Financial interests: The authors declare they have no financial interests. Non-financial interests: Authors Bart Kaptein and Maiken Stilling are on the board of The International Radiostereometry Society.

Ethics approval and consent to participate

Patients were selected from clinical studies performed on the two systems and approved by the local ethics committee [20060165, M-20100112, M-20070082, M-20110224, and 20070258] and registered with ClinicalTrials.gov [NCT00408096, NCT01289834, NCT00913679, NCT02311179, and NCT00679120].

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Jørgensen, P.B., Krag-Nielsen, N., Lindgren, L. et al. Radiostereometric analysis: comparison of radiation dose and precision in digital and computed radiography. Arch Orthop Trauma Surg 143, 5919–5926 (2023). https://doi.org/10.1007/s00402-022-04674-0

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