Cone-beam CT: As useful as MDCT before and after percutaneous vertebroplasty

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Cone-beam CT which is believed to deliver less radiation than multi-detector CT (MDCT) is just as useful when evaluating patients before and after percutaneous vertebroplasty, according to a study in the November issue of the American Journal of Roentgenology.

Percutaneous vertebroplasty is a minimally invasive cement augmentation technique to relieve pain in the back that is non-responsive to conservative treatment.

Researchers from department of clinical radiology at Kyushu University in Fukoka, Japan, examined 22 patients, who had osteoporotic compression fractures and underwent percutaneous vertebroplasty for treatment.

Before vertebroplasty, investigators said that all 75 cortical defects seen on MDCT were also observed on cone-beam CT with 100 percent sensitivity and specificity. After vertebroplasty, MDCT found cement leakages in 17 disk spaces, 15 paravertebral soft tissues and 12 veins; cone-beam CT identified all cement leakages.

“While there is no gross difference between MDCT and cone-beam CT, cone-beam CT is believed to deliver less radiation,” said Akio Hiwatashi, MD, lead author of the study.

Percutaneous vertebroplasty is common throughout the United States and European countries. It is often used when conservative treatments like pain medication, activity limitation, physical therapy and bracing is not enough.

“Patients can be safely evaluated before and after vertebroplasty using the cone-beam CT system. It is a technical advance in image guided intervention,” Hiwatashi said.