Whole body imaging in the diagnosis of blunt trauma, ionizing radiation hazards and residual risk

Abstract

Ever since the introduction of radiographic imaging, its utility in identifying injuries has been well documented and was incorporated in the workup of injured patients during advanced trauma life support algorithms [American College of Surgeons, 8th ed. Chicago, 2008]. More recently, computerized tomography (CT) has been shown to be more sensitive than radiography in the diagnosis of injury. Due to the increased use of CT scanning, concerns were raised regarding the associated exposure to ionizing radiation [N Engl J Med 357:2277-2284, 2007]. During the last several years, a significant amount of research has been published on this topic, most of it being incorporated in the BEIR VII Phase 2 report, published by the National Research Council of the National Academies [National Academy of Sciences, Washington DC, 2006]. The current review will analyze the scientific basis for the concerns over the ionizing radiation associated with the use of CT scanning and will examine the accuracy of the typical advanced trauma life support work-up for diagnosis of injuries.

Contemporary treatment of renal trauma in Canada

“…Typically, these patients are subjected to multiple CT scans during their trauma workup and management. [20][21][22] At our institution, reimaging with CT is not pursued unless a patient's clinical condition changes. Ultrasound is often used to determine whether there is a significant urinoma and this may help determine the need for further CT imaging.…”

Quality improvement in trauma care

“…However, the hazards of radiation need to be discussed, and further improvements in CT scanning technology and protocols are on the way. Kepros et al [7] reviewed the residual risks of ionizing radiation very thoroughly with respect to trauma patient care. Accordingly, further prospective studies are warranted in order to determine the optimal application of this helpful procedure.…”