Low Dose Computed Tomography for 3D Planning of Total Hip Arthroplasty: Evaluation of Radiation Exposure and Image Quality

J Comput Assist Tomogr. Sep-Oct 2015;39(5):649-56. doi: 10.1097/RCT.0000000000000271.


Objective: The aim of the study was to compare radiation exposure and image quality between dedicated computed tomography (CT) protocols for preoperative total hip arthroplasty (THA) planning.

Methods: Three protocols with automated tube current modulation using 64-slice (n = 177) and 128-slice CT scanners without (n = 129) and with automated tube voltage preselection (n = 84) were compared.

Results: All 390 CTs were of sufficient quality for THA planning. Mean DLP was 235.0 mGy*cm (effective dose 2.8 mSv). Lowest radiation exposure (2.5 mSv) was seen with automated voltage preselection and the algorithm's selection was 100 kV (90.5% of patients) and 120 kV. Lowest image noise was seen in the highest dose group (3.1 mSv, 128-slice CT fixed tube voltage). A significant difference in cortical bone radiodensity was seen between 100 kV and 120 kV (P < 0.0001).

Conclusions: Preoperative pelvic CT for THA planning is possible with very low radiation dose and reliable quality. Automated voltage preselection further decreases the effective dose by 18.2%.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip*
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Middle Aged
  • Radiation Dosage*
  • Radiation Exposure / statistics & numerical data*
  • Radiographic Image Interpretation, Computer-Assisted / methods*
  • Tomography, X-Ray Computed / methods*