Mahadevappa Mahesh MS, PhD, Presenter: Nothing to Disclose

Marissa Brunetti MD, Abstract Co-Author: Nothing to Disclose

Rosemary Nabaweesi, Abstract Co-Author: Nothing to Disclose

Susan Ziegfeld, Abstract Co-Author: Nothing to Disclose

Paul Locke PhD, JD, Abstract Co-Author: Nothing to Disclose

Robert H Brown MD, MPH, Abstract Co-Author: Nothing to Disclose

To compute the total radiation dose from all imaging studies including CT to pediatric trauma patients.

Retrospective review of all x-ray imaging undertaken on pediatric patients admitted to level 1 pediatric trauma center was performed. The radiation doses for all x-ray studies were calculated based on the published adult CT, radiography and fluoroscopy doses, cross-verified with phantom measurements and corrected to appropriate pediatric age ranges. Injury Severity Score (ISS) was calculated for each patient based on standard anatomical scoring system and injuries were classified as minor, severe and critical.

Study included 719 pediatric trauma patients (442 m, 277 f) with average age 7.8±4.6 yrs and included racial makeup of 383 white, 318 blk & 18 other. Trauma events included assault, bicycle accident, burns, falls, gunshot wounds, motor vehicle accidents and other. Out of total 4,157 x-ray imaging studies, 1,273 (31%) were CT, 2,835 (68%) were plain radiographs, and 49 (1%) were fluoroscopy studies. The overall mean radiation dose was 12.8±12.0 mSv (range: 0-73.5 mSv). The patients admitted to hospital had higher mean doses, 17.9±13.9 mSv, than patients discharged from ED, 8.4±7.7 mSv (p<0.001). No differences in the mean radiation dose by sex (p=0.22), by race (p=0.46), or by age (p=0.11). Patients with burn injuries received lowest radiation doses, (mean:1.2 ± 2.5 mSv.), while, children in motor vehicle accidents received highest radiation doses (mean:18.0 ± 14.7 mSv). CT accounted for only 31% of all x-ray studies but accounted to 91% of total dose.

Children with traumatic injuries are exposed to varying amount of radiation doses depending on type of injury & whether hospitalized or not. In trauma evaluation, rapid diagnosis is heavily dependent on imaging modalities & on its proper use. Since radiation exposure can lead to increased risk of cancer, especially in children, it is critical to ensure optimal settings for each imaging modalities (especially CT) so as to lower long-term risk from radiation. By undertaking proper precautions to lower dose, the benefits of imaging modalities including CT can be properly exploited.

Understand use of imaging studies in evaluating pediatric trauma patients. By doing so, we want to explore the options to lower doses and risks from CT, radiography and fluoroscopy studies.

Mahesh, M, Brunetti, M, Nabaweesi, R, Ziegfeld, S, Locke, P, Brown, R, Radiation Doses in Pediatric Trauma Patients.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8015224.html