Comparison of Calculated Skin Doses in Cineradiography and Four Dimensional Kinematic Computed Tomography of the Wrist

Background: Previous studies have discussed the diagnostic value of four dimensional kinematic CT in cases of carpal instabilities. This analysis compares calculated skin doses of 4D CT and conventional cineradiography of the wrist in cases of suspected SLL rupture. Methods: Retrospective calculation and interpolation of skin doses and effective doses for ten consecutive 4D CT examinations and 41 cineradiographies for suspected lesions of the scapholunate ligament. Standardised anterior-posterior and lateral cine sequences using a flat-panel digital subtraction imager and of 4D kinematic CT using a dual-source scanner were acquired and acquisition parameters recorded. We tested if the skin dose of 4D CT is different from cineradiography. Results: Median dose area product (DAP) of cineradiography was 135.34 cGycm² resulting in a calculated median skin dose of 32.6 mSv (confidence interval 26.86-42.90 mSv) and an estimated effective skin dose of 3.26 µSv. CT dose index (CTDI) for 4D examinations was recorded to be 26.79 mGy and the dose-length product (DLP) was 150 mGy × cm. This resulted in an estimated skin dose of 34 mSv, which is covered by the confidence interval of cineradiography, and an effective skin dose of 3.4 µSv. Conclusions: Skin dose calculations are comparable for 2D cineradiography in two plains and 4D kinematic CT of the wrist. Calculated effective doses are < 0.01 mSv.