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NICE doubts value of whole-body X-ray system

The first draft guidance from the new NICE Diagnostics Assessment Programme does not recommend a new whole-body X-ray system.

The provisional recommendations do not support routine use of the EOS Low Dose 2D/3D X-ray imaging system from EOS Imaging in the NHS, but recommends its use in research settings to develop evidence regarding its clinical benefits.

The EOS system uses a low radiation dose to take 2D X-ray images and 3D reconstructions of bones. By scanning a line at a time rather than the entire image, it allows upright, weight-bearing whole-body images to be taken.

This could assist the treatment of orthopaedic patients by showing the relationship between the spine, hip, pelvis and knees, as well as cutting patient turnaround times. Current imaging systems cannot show the whole spine or lower limbs in a weight-bearing position in a single image.

Professor Adrian Newland, Chair of the Diagnostics Advisory Committee, said: “This technology may have a number of potentially significant benefits for patients, and there is evidence to suggest that the system does confer some benefits in terms of reducing radiation dose. Also, simultaneous 2-view imaging may permit improved patient throughput.

“However, in order for the EOS system to be cost-effective, benefits relating to its use… need to be translated into health benefits for patients. Unfortunately there is no available evidence relating to these benefits. In particular, no data was found that compared the EOS system’s diagnostic accuracy to conventional radiological examinations.

“This, together with the high cost of the system relative to conventional methods of imaging, has led the Committee to provisionally conclude that routine use of the EOS system would not be an effective use of NHS resources.

Professor Newland also noted that NICE’s diagnostics guidance aims to indicate where a technology has “plausible potential of providing substantial benefits,” and to suggest research that could provide clear evidence of such benefits. On this basis, he said, NICE recommends further research to establish whether the EOS device offers better health outcomes.

Final guidance will be published in October 2011.

EOS X-ray

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