• Luís DuarteMárcioM0000-0002-7874-9332MD, MSc. Musculoskeletal Radiologist, WEBIMAGEM, São Paulo (SP), Brazil; and Doctoral Student in Evidence-based Health Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil., Dos SantosLucas RibeiroLR0000-0001-7897-1198MD, MSc. Endocrinologist and Professor of Physiology and Medical Clinic, Centro Universitário Lusíada (UNILUS), Santos (SP), Brazil; and Doctoral Student in Evidence-based Health Program, Universidade Federal de, OliveiraAcary Souza BulleASB0000-0002-6986-4937MD, PhD. Afliated Professor, Department of Neurology, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil., Wagner Iared, and Maria Stella Peccin.
• MD, MSc. Musculoskeletal Radiologist, WEBIMAGEM, São Paulo (SP), Brazil; and Doctoral Student in Evidence-based Health Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
• Sao Paulo Med J. 2021 Jul 1; 139 (4): 388-397.

BackgroundComputed tomography (CT) accounts for 13% of all radiological examinations in the United States and 40-70% of the radiation that patients receive. Even with the advent of magnetic resonance imaging (MRI), CT continues to be the gold standard for diagnosing bone fractures. There is uncertainty as to whether CT with a low radiation dose has a fracture detection rate similar to that of standard-dose CT.ObjectiveTo determine the detection rate of low-dose radiation CT and standard-dose radiation CT for fractures, in patients with suspected fractures.Design And SettingSystematic review of comparative studies on diagnostic accuracy within the evidence-based health program at a federal university in São Paulo (SP), Brazil.MethodsWe searched the electronic databases Cochrane Library, MEDLINE, EMBASE and LILACS up to June 29, 2020, for studies evaluating the detection rates of low-dose CT and standard-dose CT for diagnosing bone fractures. The Research Triangle Institute (RTI) item bank tool was used for methodological quality evaluation.ResultsThe fracture detection rate according to the number of bones evaluated, using CT with low-dose radiation was 20.3%, while with standard-dose radiation it was 19.2%, and the difference between the methods was not significant. The fracture detection rate according to the number of patients, using CT with low-dose radiation was 56.0%, while with standard-dose radiation it was 58.7%, and this difference between the methods was not significant, either.ConclusionCT with low-dose radiation presented detection rates similar to those of CT with standard-dose radiation, regardless of the bones evaluated.Registration NumberCRD42019148491 at the PROSPERO database.

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