Whole-body computed tomography in trauma patients: optimization of the patient scanning position significantly shortens examination time while maintaining diagnostic image quality

Introduction: The use of computed tomography (CT) imaging as a diagnostic modality is increasing rapidly and CT is the dominant contributor to diagnostic medical radiation exposure. The aim of this project was to reduce the effective radiation dose to patients undergoing cranial CT examination, while maintaining diagnostic image quality. Methods: Data from a total of 1003, 132 and 27 patients were examined for three protocols: CT head, CT angiography (CTA), and CT perfusion (CTP), respectively. Following installation of adaptive iterative dose reduction (AIDR) 3D software, tube current was lowered in consecutive cycles, in a stepwise manner and effective radiation doses measured at each step. Results: Baseline effective radiation doses for CT head, CTA and CTP were 1.80, 3.60 and 3.96 mSv, at currents of 300, 280 and 130–150 mA, respectively. Using AIDR 3D and final reduced currents of 160, 190 and 70–100 mA for CT head, CTA and CTP gave effective doses of 1.29, 3.18 and 2.76 mSv, respectively. Conclusion: We demonstrated that satisfactory reductions in the effective radiation dose for CT head (28.3%), CTA (11.6%) and CTP (30.1%) can be achieved without sacrificing diagnostic image quality. We have also shown that iterative reconstruction techniques such as AIDR 3D can be effectively used to help reduce effective radiation dose. The dose reductions were performed within a short period and can be easily achievable, even in busy departments.

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273: Is Whole Body Computed Tomography Imaging Necessary to Identify “Clinically Significant” Injuries in Low Risk Blunt Trauma Patients?

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2008.06.292 ◽

2008 ◽

Vol 52 (4) ◽

pp. S125

Author(s):

R. Wright ◽

M.J. Hughes ◽

P. Tanner ◽

K. Hughes ◽

L. Gasworth ◽

...

Keyword(s):

Computed Tomography ◽

Blunt Trauma ◽

Low Risk ◽

Whole Body ◽

Trauma Patients ◽

Computed Tomography Imaging ◽

Tomography Imaging ◽

Whole Body Computed Tomography ◽

Clinically Significant

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Whole-body computed tomography is safe, effective and efficient in the severely injured hemodynamically unstable trauma patient

10.25100/cm.v51i4.4362 ◽

2020 ◽

Author(s):

Carlos Alberto Ordoñez ◽

Michael Parra ◽

Alfonso Holguín ◽

Carlos Garcia ◽

Monica Guzmán-Rodríguez ◽

...

Keyword(s):

Computed Tomography ◽

Decision Making ◽

Damage Control ◽

Hemodynamic Instability ◽

Whole Body ◽

Trauma Patients ◽

Severely Injured ◽

Hemostatic Resuscitation ◽

Whole Body Computed Tomography ◽

Technological Advances

Trauma is a complex pathology that requires an experienced multidisciplinary team with an inherent quick decision-making capacity, given that a few minutes could represent a matter of life or death. These management decisions not only need to be quick but also accurate to be able to prioritize and to efficiently control the injuries that may be causing impending hemodynamic collapse. In essence, this is the cornerstone of the concept of Damage Control Trauma Care. With current technological advances, physicians have at their disposition multiple diagnostic imaging tools that can aid in this prompt decision-making algorithm. This manuscript aims to perform a literature review on this subject and to share the experience on the use of Whole Body Computed Tomography as a potentially safe, effective, and efficient diagnostic tool in cases of severely injured trauma patients regardless of their hemodynamic status. Our general recommendation is that, when feasible, perform a Whole-Body Computed Tomography without interrupting ongoing hemostatic resuscitation in cases of severely injured trauma patients with or without signs of hemodynamic instability. The use of this technology will aid in the decision-making of the best surgical approach for these patients without incurring any delay in definitive management and/or increasing significantly their radiation exposure.

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