Abstract Background The use of Whole-Body Computed Tomography (WBCT) is becoming the standard of care for trauma patients as a first approach in the emergency setting. Radiation exposure is one of its major drawbacks. The use of a low-dose WBCT may be the answer to reduce radiation exposure. However, few studies have investigated the impact in clinical practice. This scoping review collected the available evidence comparing dose-reduction strategies in WBCT with the standard of care protocol. Methods This study is a scoping review of technical data, the use and effects of low-dose CT in injured patients. Electronic searches were performed using Ovid Medline, Cochrane CENTRAL, Embase, LILACS, Scielo, WPRIM from the date of inception to 5 March 2024. Unpublished trials were identified by searching trial registers, clinicaltrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP), the Cochrane central register of Controlled Trials, conference abstracts and theses. Results Twenty-two articles were included, mostly observational and retrospective. Only one prospective randomised trial was reported. The methods used to reduce the dose were the use of an iterative reconstruction technique in 6 studies, a split bolus technique in 8 studies, a different arm positioning in 4 studies, and a single-pass continuous whole-body acquisition technique in 3 studies. The image quality of the low-dose protocols was generally similar or inferior, but the diagnostic capacity remained the same. The lowest effective dose achieved in the different studies for effective dose was 4.8 mSv for a protocol combining iterative reconstruction with a split-bolus. Conclusion Across studies, a consistent trend of dose reduction was observed with all strategies, with larger reductions reported for split-bolus protocols. However, direct comparisons were limited by heterogeneity in study designs, scan protocols, and reporting measures of effect, precluding definitive conclusions about the relative superiority of any single approach. Image quality did not seem to be affected by dose reduction. However, there was an increase in missed diagnoses of arterial injury. Direct comparisons were limited by heterogeneity in study designs, scan protocols, and reporting measures of effect, precluding definitive conclusions about the relative superiority of any single approach.
Pereira et al. (Mon,) studied this question.