Radiation doses in diagnostic imaging for suspected physical abuse. Issue 9 (17th April 2019)

• Record Type: Journal Article
• Authors: Rao, Raylene; Browne, Diana; Lunt, Brian; Perry, David; Reed, Peter; Kelly, Patrick
• Is Part Of: Archives of disease in childhood. Volume 104:Issue 9(2019)
• Page Start: 863
• Page End: 868
• Publication Date: 2019-04-17
• Subjects: physical abuse -- radiography -- radionuclide imaging -- patient education handout; Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2018-316286
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Objective: To measure the actual radiation dose delivered by imaging techniques commonly used in the radiography of suspected physical abuse and to make this information available to health professionals and families. Methods: Data were collected retrospectively on children under 3 years referred for skeletal surveys for suspected physical abuse, non-contrast CT head scan or radionuclide imaging of the bones in Starship Children's Hospital, Auckland, New Zealand from January to December 2015. Patient size-specific conversion coefficients were derived from International Commission on Radiologic Protection tissue weighting factors and used to calculate effective dose. Results: Seventy-one patients underwent an initial skeletal survey, receiving a mean effective dose of 0.20 mSv (95% CI 0.18 to 0.22). Sixteen patients had a follow-up survey with a mean effective dose of 0.10 mSv (95% CI 0.08 to 0.11). Eighty patients underwent CT head which delivered a mean effective dose of 2.49 mSv (95% CI 2.37 to 2.60). Thirty-nine patients underwent radionuclide bone imaging which delivered a mean effective dose of 2.27 mSv (95% CI 2.11 to 2.43). Conclusions: In a paediatric centre, skeletal surveys deliver a relatively low effective radiation dose, equivalent to approximately 1 month of background radiation. Non-contrast CT head scan and radionuclide bone imaging deliver similar doses, equivalent to approximately 1 year of background radiation. This information should be considered when gaining informed consent and incorporated in patient education handouts.