Radiation exposure of chest and abdomen computed tomography in pediatric trauma patients

Background: Combined chest and abdomen CT in pediatric trauma patients is rare and typically reserved for severely injured patients due to concerns about the potential radiation risks associated with CT in children. This study aims to analyze the radiation exposure of chest and abdomen CT in pediatric patients following trauma resuscitation. Materials and Methods: A retrospective single-center study was conducted on patients aged 0-<15 years who underwent CT in the trauma resuscitation unit between 04/2020 and 08/2023. Patients were categorized into three age groups (I: 0-<5 years, II: 5-<10 years, III: 10-<15 years) and radiation exposure parameters were analyzed age-stratified. Effective dose (ED) was calculated using conversion factors and organ doses were determined through Monte Carlo simulations. Results: Out of 212 pediatric patients, 62.7% (133/212) received a CT scan, with 60.2% (80/133) undergoing combined chest and abdomen CT. In 70.0% (56/80), the standard protocol was applied, complete dose data available, and these were included in the dose calculation (median age: 6.2 years; IQR: 3.9-10.5 years; 37.5% female). Radiation exposure was as follows (median [IQR] CTDIvol, DLP, ED): chest: I: 0.7 mGy (0.5-0.8), 13 mGycm (10-16), 2.1 mSv (1.6-2.4); II: 1.4 mGy (1.1-1.9), 35 mGycm (25-49), 3.7 mSv (2.7-5.2); III: 2.7 mGy (2.2-3.2), 76 mGycm (66-95), 4.3 mSv (3.7-5.3); abdomen: I: 0.8 mGy (0.6-0.9), 24 mGycm (20-29), 2.0 mSv (1.6-2.5); II: 1.6 mGy (1.1-1.9), 60 mGycm (41-77), 3.2 mSv (2.2-4.2); III: 3.1 mGy (2.4-3.9), 143 mGycm (101-179), 4.3 mSv (3.0-5.4). In the organ dose analysis, the genital organs were particularly affected by increased radiation exposure. 16.1% (9/56) of patients were not scanned using age-adapted protocols. Conclusion: Chest and abdomen CT in pediatric trauma patients can be performed with moderate radiation exposure. Nonetheless, non-adherence to age-adapted protocols highlights the need for improved compliance to ensure optimal radiation safety in pediatric trauma imaging.