Journal article
Variation in radiation dosing among pediatric trauma patients undergoing head computed tomography scan
The journal of trauma and acute care surgery, Vol.91(3), pp.566-570
09/01/2021
DOI: 10.1097/TA.0000000000003318
PMID: 34137741
Abstract
BACKGROUND When head injured children undergo head computed tomography (CT), radiation dosing can vary considerably between institutions, potentially exposing children to excess radiation, increasing risk for malignancies later in life. We compared radiation delivery from head CTs at a level 1 pediatric trauma center (PTC) versus scans performed at referring adult general hospitals (AGHs). We hypothesized that children at our PTC receive a significantly lower radiation dose than children who underwent CT at AGHs for similar injury profiles. METHODS We retrospectively reviewed the charts of all patients younger than 18 years who underwent CT for head injury at our PTC or at an AGH before transfer between January 1 and December 31, 2019. We analyzed demographic and clinical data. Our primary outcome was head CT radiation dose, as calculated by volumetric CT dose index (CTDIvol) and dose-length product (DLP; the product of CTDIvol and scan length). We used unadjusted bivariate and multivariable linear regression (adjusting for age, weight, sex) to compare doses between Children's Hospital Los Angeles and AGHs. RESULTS Of 429 scans reviewed, 193 were performed at our PTC, while 236 were performed at AGHs. Mean radiation dose administered was significantly lower at our PTC compared with AGHs (CTDIvol 20.3/DLP 408.7 vs. CTDIvol 30.6/DLP 533, p < 0.0001). This was true whether the AGH was a trauma center or not. After adjusting for covariates, findings were similar for both CTDIvol and DLP. Patients who underwent initial CT at an AGH and then underwent a second CT at our PTC received less radiation for the second CT (CTDIvol 25.6 vs. 36.5, p < 0.0001). CONCLUSIONS Head-injured children consistently receive a lower radiation dose when undergoing initial head CT at a PTC compared with AGHs. This provides a basis for programs aimed at establishing protocols to deliver only as much radiation as necessary to children undergoing head CT.
Details
- Title: Subtitle
- Variation in radiation dosing among pediatric trauma patients undergoing head computed tomography scan
- Creators
- Michael J. LaQuaglia - Children's Hospital of Los AngelesMelissa Anderson - University of Southern CaliforniaCatherine J. Goodhue - Children's Hospital of Los AngelesMaria Bautista-Durand - University of Southern CaliforniaRyan Spurrier - Childrens Hosp Los Angeles, Div Pediat Surg, Los Angeles, CA 90027 USAShadassa Ourshalimian - Childrens Hosp Los Angeles, Div Pediat Surg, Los Angeles, CA 90027 USALillian Lai - Childrens Hosp Los Angeles, Dept Radiol, Los Angeles, CA 90027 USAPhilip Stanley - Childrens Hosp Los Angeles, Dept Radiol, Los Angeles, CA 90027 USAPradip P. Chaudhari - Childrens Hosp Los Angeles, Div Emergency & Transport Med, Los Angeles, CA 90027 USADavid Bliss - Childrens Hosp Los Angeles, Div Pediat Surg, Los Angeles, CA 90027 USA
- Resource Type
- Journal article
- Publication Details
- The journal of trauma and acute care surgery, Vol.91(3), pp.566-570
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/TA.0000000000003318
- PMID
- 34137741
- ISSN
- 2163-0755
- eISSN
- 2163-0763
- Number of pages
- 5
- Language
- English
- Date published
- 09/01/2021
- Academic Unit
- Radiology
- Record Identifier
- 9984318796602771
Metrics
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