One size does not fit all trauma patients undergoing whole-body CT

When it comes to optimizing image quality of whole-body CT for trauma patients, “one-size-fits-all” patient positioning is no match for positioning that takes into account the patient’s individual injury state. The adaptable approach can also allow a substantial reduction in radiation exposure.

That’s according to the authors of a study published online Nov. 12 in the German radiology journal RöFo.

Stefan Reske of the University of Halle-Wittenberg and colleagues compared their trauma center’s old protocol for whole-body CT with two new, differently weighted protocols. One called the TIME protocol was used for hemodynamically unstable patients and the other, their DOSE protocol, for patients with stable vital signs.

The team retrospectively evaluated the three approaches as applied to 308 patients. They looked at several regions of interest and imaging variables, including waist circumference, injury severity score, exam time, image noise and effective dose.

While there was no significant difference in image noise between the old protocol and the TIME protocol, Reske and his team achieved significant noise reduction with their DOSE protocol, which calls for positioning the patient’s arms over the head.

They also found effective dose could be reduced from 49.7 mSv to 35.4 mSv by optimizing automatic exposure control. And by repositioning the patients’ arms as called for in the DOSE protocol, they realized an additional dose reduction to 28.2 mSv.

Automatic exposure control and arm repositioning “have a crucial influence on image quality and dose,” the authors conclude, adding that the use of two differently weighted whole-body CT protocols “allows a more flexible approach to the patient's clinical presentation.”

Dave Pearson

Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.

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