Radiation doses from techniques used to assess low-energy fractures
VFA is a low-dose technique with doses reported to be from 0.002 to about 0.05 mSv [22–24]. Although spine radiography is the reference standard for the detection of vertebral fractures, VFA is associated with considerably lower exposure to the patient [25]. The dose from a lateral radiograph of the thoracic and lumbar spine is about 0.6 mSv [22]. Obviously, the advantage of VFA with respect to radiation dose is doubtful when the examination is used in combination with spinal radiographs. MDCT is not performed specifically for vertebral fracture diagnosis. However, fracture assessment of the spine is possible without any additional radiation burden by routinely performing sagittal reformations in 3D CT of the thorax and abdomen which have been performed for other clinical indications. In addition the lateral digital radiographs (scout views) may be used for fracture assessment. Radiographs are preferable to CT for routine diagnosis of vertebral fractures, partly because of the lower radiation dose. Bauer et al. [26] state that a low-dose CT protocol for visualisation of the spine is associated with a dose of 2.2 mSv for men and 3.3 mSv for women.