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Skeletal surveys for suspected infant abuse: patient-specific radiation dose estimation using a hybrid computational
Danielle Beaulieu1, Da Zhang1, Jeannette M Pérez-Rosselló1
1Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
Insights
This study accurately estimated radiation doses from infant skeletal surveys using hybrid computational phantoms. Findings help optimize imaging protocols for diagnosing child abuse while minimizing radiation exposure.
Area of Science:
- Medical Imaging
- Radiological Physics
- Pediatric Radiology
Background:
- Radiographic skeletal surveys are crucial for diagnosing infant abuse.
- Concerns exist regarding radiation exposure from these examinations.
Purpose of the Study:
- To accurately estimate radiation doses from skeletal surveys in infants suspected of abuse.
- To utilize advanced hybrid computational phantoms for precise dosimetry.
Main Methods:
- Identified skeletal surveys from 5/2020-5/2022.
- Applied the National Cancer Institute dosimetry system with 3D Monte Carlo simulation.
- Utilized male and female infant hybrid computational phantoms for patient-specific dose estimation.
Main Results:
- Mean effective radiation doses were 0.627 mSv (initial) and 0.495 mSv (follow-up).
- Anteroposterior chest radiographs were the largest contributors to effective dose.
- Specific organs received highest doses depending on survey type and contributing radiographs.
Conclusions:
- Hybrid computational phantoms provide improved radiation dose estimation for infant skeletal surveys.
- Results enable optimization of imaging protocols for diagnosing child abuse.
- This research supports minimizing radiation exposure in a critical diagnostic procedure.
Background:
Radiographic skeletal survey plays an important role in the diagnosis of infant abuse. Some practitioners have expressed concerns about the radiation exposure from this examination.
Objective:
To utilize state-of-the-art hybrid computational phantoms to more accurately estimate radiation doses of skeletal surveys performed for suspected infant abuse.
Materials And Methods:
We searched our imaging database to identify skeletal surveys performed for suspected infant abuse (5/2020-5/2022). Initial skeletal surveys consisted of 25 standardized radiographs while follow-up skeletal surveys consisted of 16 standardized radiographs (no frontal or lateral views of the skull; or lateral views of the spine, knees, and ankles). To estimate the patient-specific organ and effective dose, we applied the National Cancer Institute dosimetry system for Radiography and Fluoroscopy (with on-the-fly 3D Monte Carlo simulation) to the male and female infant hybrid computational phantoms.
Results:
The mean total effective radiation dose was 0.627 mSv (initial survey) and 0.495 mSv (follow-up survey). For both surveys, the anteroposterior chest radiograph was the largest contributor to effective dose (contributing 0.101 mSv and 0.108 mSv, respectively). In the initial skeletal survey, the lens and the eyeballs received the highest organ absorbed doses (with the skull radiographs as the major contributors); and in the follow-up skeletal survey, the breasts received the highest organ absorbed dose (with the chest radiographs as the major contributors).
Conclusions:
We employed hybrid computational phantoms to better estimate the radiation profile of skeletal surveys performed for suspected infant abuse, thus enabling us to update and optimize this life-saving imaging protocol.
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