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Ultra-low-dose CT in extremity fracture detection: A systematic review and meta-analysis
Journal article   Peer reviewed

Ultra-low-dose CT in extremity fracture detection: A systematic review and meta-analysis

Vanessa Veltre, Gabrielle Feher, Christian Pecoraro, Jonathan Elias, Peter Mahany and Judah Goldschmiedt
Emergency radiology, v 33(1), pp 129-139
01 Feb 2026
PMID: 41291353

Abstract

Life Sciences & Biomedicine Radiology, Nuclear Medicine & Medical Imaging Science & Technology
To compare the diagnostic accuracy and radiation doses of ultra-low-dose CT (ULD-CT) versus standard-dose CT (SD-CT) in patients with suspected limb joint fractures. Methods: A systematic review and meta-analysis were conducted following 2020 PRISMA guidelines. Five databases (PubMed, Cochrane, Embase, Scopus, Web of Science) were screened for studies directly comparing ULD-CT to SD-CT diagnostic accuracy for limb joint fractures. Studies used 320-row detector CT scanners with ULD-CT protocols (80 kVp, 4-52 mAs) versus conventional protocols (120 kVp, 50-150 mAs). Bivariate random effects meta-analysis was used to pool sensitivity and specificity estimates. Dose-length product (DLP) reductions were compared directly. Results: Four prospective studies comprising 674 patients met inclusion criteria. ULD-CT demonstrated pooled sensitivity of 97.6% and specificity of 99.6% (AUC 99.0%), while SD-CT showed sensitivity of 99.4% and specificity of 99.1% (AUC 98.9%). Subgroup analysis revealed no significant differences in sensitivity (p = 0.300) or specificity (p = 0.486). ULD-CT achieved radiation dose reductions of 87-99% across all anatomical regions. Conclusions: ULD-CT offers significant radiation dose reduction with diagnostic accuracy comparable to SD-CT for limb joint fracture detection. Further multicenter studies are warranted to consolidate evidence across anatomical regions.

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Collaboration types
Domestic collaboration
Web of Science research areas
Radiology, Nuclear Medicine & Medical Imaging
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