BACKGROUND: We report our use of portable head computed tomography (CT) and the diagnostic yield and radiation dose from head CT in the pediatric intensive care unit (PICU). METHODS: 204 PICU patients underwent head CT during 2008-2009. Therapeutic interventions and resource intensity during CT were categorized. Severity of illness was summarized using the pediatric risk of mortality (PRISM-III) model. Estimates of patient radiation dose were based on dose measurements made in four anthropomorphic head phantoms. RESULTS: 242 (62%) out of 391 head CT studies were portable. New pathology was identified on 80 (40%) scans. CT findings prompted a change in management in 46 (23%) patients; 25 of these resulted in life-extending treatments and 21 had forgoing of life-sustaining treatments within 24 hours. 26 patients with PRISM score greater than 30% underwent CT; 23 (88%) of these were portable. More portable versus fixed examinations were performed in patients requiring extracorporeal membrane oxygenation, inhaled nitric oxide, high levels of positive end expiratory pressure, and those with high vasopressor scores (P < 0.05). Estimated patient dose from portable CT was 83 ± 6 mGy compared to 72 ± 5 mGy for patients imaged on a fixed scanner (P < 0.0001). CONCLUSION: Two-thirds of CT scans obtained in the PICU were portable because of patients' intensity of therapy and illness severity. Portable CT showed major new pathology in greater than 1/3 and led to a change in management in 1/4 of higher acuity patients scanned. The estimated radiation dose from portable CT is within the current national guidelines.
BACKGROUND: We report our use of portable head computed tomography (CT) and the diagnostic yield and radiation dose from head CT in the pediatric intensive care unit (PICU). METHODS: 204 PICU patients underwent head CT during 2008-2009. Therapeutic interventions and resource intensity during CT were categorized. Severity of illness was summarized using the pediatric risk of mortality (PRISM-III) model. Estimates of patient radiation dose were based on dose measurements made in four anthropomorphic head phantoms. RESULTS: 242 (62%) out of 391 head CT studies were portable. New pathology was identified on 80 (40%) scans. CT findings prompted a change in management in 46 (23%) patients; 25 of these resulted in life-extending treatments and 21 had forgoing of life-sustaining treatments within 24 hours. 26 patients with PRISM score greater than 30% underwent CT; 23 (88%) of these were portable. More portable versus fixed examinations were performed in patients requiring extracorporeal membrane oxygenation, inhaled nitric oxide, high levels of positive end expiratory pressure, and those with high vasopressor scores (P < 0.05). Estimated patient dose from portable CT was 83 ± 6 mGy compared to 72 ± 5 mGy for patients imaged on a fixed scanner (P < 0.0001). CONCLUSION: Two-thirds of CT scans obtained in the PICU were portable because of patients' intensity of therapy and illness severity. Portable CT showed major new pathology in greater than 1/3 and led to a change in management in 1/4 of higher acuity patients scanned. The estimated radiation dose from portable CT is within the current national guidelines.
Authors: M B Matson; J M Jarosz; D Gallacher; P N Malcolm; J A Holemans; C Leong; P T Seed; A B Ayers; S C Rankin Journal: Br J Radiol Date: 1999-07 Impact factor: 3.039
Authors: Daniel Lahner; Ajsa Nikolic; Peter Marhofer; Herbert Koinig; Peter Germann; Christian Weinstabl; Claus G Krenn Journal: Wien Klin Wochenschr Date: 2007 Impact factor: 1.704
Authors: Michael M Maher; Peter F Hahn; Debra A Gervais; Brid Seoighe; James B Ravenscroft; Peter R Mueller Journal: AJR Am J Roentgenol Date: 2004-09 Impact factor: 3.959
Authors: W E Butler; C M Piaggio; C Constantinou; L Niklason; R G Gonzalez; G R Cosgrove; N T Zervas Journal: Neurosurgery Date: 1998-06 Impact factor: 4.654
Authors: Mercy H Mazurek; Bradley A Cahn; Matthew M Yuen; Anjali M Prabhat; Isha R Chavva; Jill T Shah; Anna L Crawford; E Brian Welch; Jonathan Rothberg; Laura Sacolick; Michael Poole; Charles Wira; Charles C Matouk; Adrienne Ward; Nona Timario; Audrey Leasure; Rachel Beekman; Teng J Peng; Jens Witsch; Joseph P Antonios; Guido J Falcone; Kevin T Gobeske; Nils Petersen; Joseph Schindler; Lauren Sansing; Emily J Gilmore; David Y Hwang; Jennifer A Kim; Ajay Malhotra; Gordon Sze; Matthew S Rosen; W Taylor Kimberly; Kevin N Sheth Journal: Nat Commun Date: 2021-08-25 Impact factor: 14.919