Image quality and patient satisfaction in cone-beam and multidetector computed tomography of the wrist: a randomized trial

Abstract Background Musculoskeletal cone-beam computed tomography (CBCT) is an imaging technique for wrist assessment. In this study, we compared image quality and patient satisfaction between CBCT and multidetector computed tomography (MDCT) in traumatic wrist patients in a dose-matched setting. Methods We prospectively enrolled traumatic patients who were scheduled for CT of the wrist. Patients were randomly assigned to CBCT or MDCT. Radiation dose was kept identical between both modalities. Subsequently, patients were asked to complete a questionnaire regarding the examination. Measurements of contrast-to-noise ratio (CNR) were performed. Three blinded readers independently rated image quality on Likert scales. Results A total of 125 patients (mean age 35 years [standard deviation 16]; 91 men) were included. A total of 108 patients returned the questionnaire. With equivalent dose, CNRs were higher in CBCT compared to MDCT ( p < 0.001) and the median ratings of image quality were better for CBCT compared to MDCT ( p ≤ 0.04). Patients only rated positioning in CBCT as more comfortable than in MDCT ( p < 0.001), while there were no further differences regarding satisfaction with both modalities. Conclusions At equivalent dose settings to MDCT, CBCT showed a high image quality for the depiction of bony structures, soft tissue and artifacts in wrist examinations of trauma patients. Overall, patients were equally satisfied with both methods. Altogether, CBCT might be a promising alternative for wrist imaging. However, further studies with more different devices are needed.