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. 2015 Mar;88(1047):20140616.
doi: 10.1259/bjr.20140616. Epub 2015 Jan 16.

Whole-body CT-based imaging algorithm for multiple trauma patients: radiation dose and time to diagnosis

S Gordic  1 , H Alkadhi, S Hodel, H-P Simmen, M Brueesch, T Frauenfelder, G Wanner, K Sprengel
Affiliations

Whole-body CT-based imaging algorithm for multiple trauma patients: radiation dose and time to diagnosis

S Gordic et al. Br J Radiol. 2015 Mar.

Abstract

Objective: To determine the number of imaging examinations, radiation dose and the time to complete trauma-related imaging in multiple trauma patients before and after introduction of whole-body CT (WBCT) into early trauma care.

Methods: 120 consecutive patients before and 120 patients after introduction of WBCT into the trauma algorithm of the University Hospital Zurich were compared regarding the number and type of CT, radiography, focused assessment with sonography for trauma (FAST), additional CT examinations (defined as CT of the same body regions after radiography and/or FAST) and the time to complete trauma-related imaging.

Results: In the WBCT cohort, significantly more patients underwent CT of the head, neck, chest and abdomen (p < 0.001) than in the non-WBCT cohort, whereas the number of radiographic examinations of the cervical spine, chest and pelvis and of FAST examinations were significantly lower (p < 0.001). There were no significant differences between cohorts regarding the number of radiographic examinations of the upper (p = 0.56) and lower extremities (p = 0.30). We found significantly higher effective doses in the WBCT (29.5 mSv) than in the non-WBCT cohort (15.9 mSv; p < 0.001), but fewer additional CT examinations for completing the work-up were needed in the WBCT cohort (p < 0.001). The time to complete trauma-related imaging was significantly shorter in the WBCT (12 min) than in the non-WBCT cohort (75 min; p < 0.001).

Conclusion: Including WBCT in the initial work-up of trauma patients results in higher radiation doses, but fewer additional CT examinations are needed, and the time for completing trauma-related imaging is shorter.

Advances in knowledge: WBCT in trauma patients is associated with a high radiation dose of 29.5 mSv.

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Figures

Figure 1.
Figure 1.
The current multiple trauma algorithm of our hospital. ABC, airway/breathing/circulation; CPR, cardiopulmonary resuscitation; FAST, focused assessment with sonography for trauma; WBCT, whole-body CT.
Figure 2.
Figure 2.
Estimated effective radiation doses per patient among cohorts. WBCT, whole-body CT.
Figure 3.
Figure 3.
Box plots showing the differences between times to complete trauma-related diagnostic work-up among cohorts. The horizontal lines in boxes correspond to the mean. The top and bottom of the boxes correspond to the second and third quartiles. The vertical lines extend to the mean ± 1.5 times the interquartile range. WBCT, whole-body CT.
Figure 4.
Figure 4.
Time to additional CT imaging examinations for obtaining complete trauma-related diagnostic work-up in the non-whole-body CT cohort.
See this image and copyright information in PMC

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