Fewer CTs, Shorter Work-Up Time, Higher Dose for Trauma Patients

Fewer additional CT examinations are needed for trauma patients when whole-body CT (WBCT) is introduced into early trauma care, according to a study published in The British Journal of Radiology.

Researchers from Switzerland undertook a study 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 WBCT into early trauma care.

A total of 240 patients participated in the study: 120 before initiation of WBCT and 120 after initiation. The researchers compared the number and type of CT, radiography, focused assessment with sonography for trauma (FAST), additional CT examinations, and the time to complete trauma-related imaging.

The results showed that the trauma patients imaged after initiation of the WBCT underwent significantly more CTs of the head, neck, chest, and abdomen than did those before WBCT, but there were significantly fewer CT examinations of the cervical spine, chest, and pelvis. FAST examinations were also significantly lower.

The researchers did not find significant differences between cohorts regarding the number of radiographic examinations of the upper and lower extremities. “We found significantly higher effective doses in the WBCT (29.5 mSv) than in the non-WBCT cohort (15.9 mSv), but fewer additional CT examinations for completing the work-up were needed in the WBCT cohort,” they wrote.

The time to complete trauma-related imaging was 12 minutes for the WBCT cohort and 75 minutes for the non-WBCT cohort.

The researchers concluded that while including WBCT in the initial work-up of trauma patients results in higher radiation doses, the time it takes to complete the work up is significantly shorter than without WBCT and fewer additional CT examinations are needed.