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Evaluation of over 100 scanner-years of computed tomography daily quality control data.

ABSTRACT: The results of a long-term, comprehensive CT quality control (QC) program were analyzed to investigate differences in failure rates based on QC test, scanner utilization pattern, and number of channels, as well as explore issues regarding testing frequency.CT QC data were collected over a 4-yr period for 26 CT scanners representing two different vendors and using three different QC programs culminating in over 100 scanner-years of QC data. QC tests analyzed included water tests [mean CT number, standard deviation, and uniformity], linearity tests [air, water, and acrylic], and artifact analysis [water phantom and large phantom]. The data were organized based on scanner use, number of channels, scanner modality, and QC test. Logistic regression model analysis with generalized estimating equation method was used to estimate failure rates for each group.A significant difference between failure rates with respect to QC test was found (p-value = 0.02). Large phantom artifacts, standard deviation of water, and water phantom artifacts had the three highest failure rates. No significant difference was found between failure rates organized by scanner use, scanner modality, or number of channels.Standard deviation of water is the most important quantitative value to collect as part of a daily QC program. Uniformity and linearity tests have relatively low failure rates and, therefore, may not require daily verification. While its failure rates were moderate, daily artifact analysis is suggested due to its potentially high impact on clinical image quality. Weekly or monthly large phantom artifact analysis is encouraged for those sites possessing an appropriate phantom.

SUBMITTER: Nute JL

PROVIDER: S-EPMC4032413 | biostudies-other | 2013 May

REPOSITORIES: biostudies-other

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Project description:BackgroundThe posterior malleolus component of the trimalleolar ankle fracture has posed a controversial topic for diagnostic imaging and surgical management. Preoperative computed tomography (CT) scans are used to better appreciate fracture morphology and may affect management techniques. No prior study has investigated the trend in preoperative CT scan use and the rates of posterior and syndesmotic fixation for trimalleolar injuries.MethodsThis retrospective cohort study evaluated the use of preoperative CT scans and the rates of posterior and syndesmotic fixation for trimalleolar ankle fractures over a 10-year period at an adult level 1 trauma center. Patients surgically managed for ankle fractures with OTA/AO classifications of 44B3, 44C3.3, 44C1.3, 44C2.3, and 44A3 were identified and included using Current Procedural Terminology codes and a prospectively collected fracture registry. Demographic information, comorbidities, fixation methods, and use of preoperative CT scan were recorded. Comparative analyses were performed to assess for yearly differences in demographic characteristics along with changes in trends of preoperative CT scans and posterior and syndesmotic fixation.ResultsA total of 1191 patients were included in the analyses. OTA/AO 44B3.2 fractures were the most common injuries (yearly range of 59.4%-80.1%). The rate of posterior fixation did not significantly increase during the study interval (1.4% growth per year [95% CI -0.27, 3.07]). However, the rate of preoperative CT scan use significantly increased by 2.76% (95% CI 1.99, 3.52) per year and the rate of syndesmotic fixation increased by 2.58% (95% CI 1.17, 3.99) per year. Fixation methods for both the syndesmosis and posterior malleolus changed during the study timeline.ConclusionDespite a relatively stable rate of posterior fixation, the frequency of preoperative CT scans and use of syndesmotic fixation increased significantly over a 10-year study period.Level of evidenceLevel IV, descriptive pilot study.

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Evaluation of over 100 scanner-years of computed tomography daily quality control data.

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