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An Analysis of Computed Tomography-Related Radiation Exposure in Pediatric Trauma Patients
Michael Hrdy1, Mahadevappa Mahesh2, Marlene Miller1
1From the Department of Pediatrics.
Insights
Pediatric CT scans at referring facilities (RF) use higher radiation doses than at pediatric trauma centers (PTC). Further research is needed to understand and reduce these increased radiation exposures in children.
Area of Science:
- Radiology
- Pediatric Imaging
- Radiation Oncology
Background:
- Computed tomography (CT) is a common imaging modality in pediatric care.
- Variations in radiation dose exist between different healthcare facilities.
- Ensuring consistent and appropriate radiation exposure is crucial for pediatric patients.
Purpose of the Study:
- To compare radiation doses for pediatric CT scans performed at community-based referring facilities (RF) versus a designated pediatric trauma center (PTC).
- To assess the consistency of radiation exposure in pediatric CT imaging across different facility types.
Main Methods:
- Retrospective study of pediatric patients (0-18 years) undergoing CT scans between January 2015 and January 2016.
- Data collected included patient demographics, CT radiation dose (mean dose-length product [DLP]), and facility characteristics.
- Comparison of radiation doses between scans performed at RFs and PTCs.
Main Results:
- A total of 502 pediatric patients were included (156 RF, 346 PTC).
- Radiation doses were significantly higher for RF scans compared to PTC scans for both head CTs (RF DLP = 545 ± 334 vs. PTC DLP = 438 ± 186, P < 0.001) and abdomen/pelvis CTs (RF DLP = 279 ± 160 vs. PTC DLP = 181 ± 201, P = 0.027).
- A trend towards lower head CT radiation doses was observed in RFs with dedicated pediatric emergency departments.
Conclusions:
- Pediatric CT scans at referring facilities are associated with significantly higher radiation doses compared to pediatric trauma centers.
- These findings highlight the need for further investigation into factors contributing to increased radiation exposure.
- Educational outreach to referring facilities is recommended to standardize radiation practices and improve patient safety.
Objective:
To compare radiation doses used for pediatric computed tomography (CT) scans at community-based referring facilities (RF) to those at a designated pediatric trauma center (PTC) to assess the consistency of radiation exposure.
Methods:
In this retrospective study, patients 0 to 18 years of age with CT imaging performed either at a RF or at a PTC from January 1, 2015, to January 5, 2016, were identified. Data about patients, CT radiation dose, and characteristics of the RFs were compared.
Results:
We identified 502 patients (156 RF, 346 PTC) with 281 head CTs (79 RF, 202 PTC) and 86 abdominal/pelvis CTs (28 RF, 58 PTC). The radiation dose (measured in mean dose-length product [DLP] ± 1 standard deviation) was significantly higher for RF scans compared with PTC scans (head, RF DLP = 545 ± 334 vs PTC DLP = 438 ± 186 (P < 0.001); abdomen/pelvis, RF DLP = 279 ± 160 vs PTC DLP = 181 ± 201 [P = 0.027]). There was a nonsignificant trend toward lower head CT radiation dosages at RFs with a dedicated pediatric emergency department compared with RFs without a pediatric emergency department.
Conclusions:
Our data suggest that CT scans performed at RFs expose pediatric patients to significantly higher doses of radiation when compared with a PTC. These data support further study to identify factors associated with increased radiation and educational outreach to RFs.
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