The effect of trauma backboards on computed tomography radiation dose. Issue 5 (May 2016)

• Record Type: Journal Article
• Authors: Lee, A.Y.; Elojeimy, S.; Kanal, K.M.; Linnau, K.F.; Gunn, M.L.
• Is Part Of: Clinical radiology. Volume 71:Issue 5(2016)
• Page Start: 499.e1
• Page End: 499.e8
• Publication Date: 2016-05
• Subjects: Medical radiology -- Periodicals; Radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiology -- Periodicals; Societies, Medical -- Periodicals; Medical radiology; Radiotherapy; Electronic journals; Periodicals; 616.0757
• DOI: 10.1016/j.crad.2016.01.006
• Languages: English
• ISSNs: 0009-9260

Abstract

Abstract : Aim: To assess the effect of trauma backboards on the radiation dose at computed tomography (CT) when using automatic tube current modulation (ATCM). Materials and methods: An anthropomorphic phantom was scanned with two commercially available CT systems (GE LightSpeed16 Pro and Siemens Definition AS+) without and with backboards. Tube current–time product (mAs), and CTDIvol (mGy) were recorded for each examination. Thermoluminescent dosimeters were used to measure skin entrance dose in the pelvis and breast. Statistical significance was determined using a two-sample t -test. In addition, an institutional review board-approved retrospective image review was performed to quantify the frequency of backboard use during CT in the emergency department. Results: There was a statistically significant increase in maximum tube current–time product ( p <0.05) and CTDIvol ( p <0.05) with the presence of a backboard; tube current–time product increased up to 31% and CTDIvol increased up to 27%. There was a significant increase in skin entrance dose in the anterior and posterior pelvis ( p <0.05) with the presence of a backboard; skin entrance dose increased up to 25% in the anterior pelvis. Skin entrance dose to the breast increased with a backboard, although this was not statistically significant. The frequency of backboard use during CT markedly decreased (from 77% to 3%) after instituting a multidisciplinary policy to promptly remove patients from backboards upon arrival to the emergency department after a primary clinical survey. Conclusions: Using backboards during CT with ATCM can significantly increase the radiation dose. Although the decision to maintain patients on backboards is multifactorial, attempts should be made to minimise backboard use during CT when possible. Highlights: Backboards significantly attenuate photons. Backboard use during CT scanning with ATCM results in increased tube current. Backboard use during CT scanning with ATCM results in increased radiation output. Entrance skin dose increased when a backboard was used during CT scanning. Attempts should be made to minimize backboard use during CT scanning when possible.