R Hinzpeter1, T Boehm2, D Boll3, C Constantin4, F Del Grande5, V Fretz6, S Leschka7, T Ohletz8, M Brönnimann9, S Schmidt10, T Treumann11, P-A Poletti12, Hatem Alkadhi13. 1. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistr. 100, CH-8091, Zurich, Switzerland. 2. Department of Radiology, Kantonsspital Graubuenden, Chur, Switzerland. 3. Department of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland. 4. Department of Radiology, Spital Wallis, Visp, Switzerland. 5. Department of Radiology, Ospedale Regionale di Lugano, Lugano, Switzerland. 6. Institute of Radiology and Nuclear Medicine, Kantonsspital Winterthur, Winterthur, Switzerland. 7. Division of Radiology and Nuclear Medicine, Kantonsspital St Gallen, Gallen, Switzerland. 8. Department of Radiology, Kantonsspital Aarau, Aarau, Switzerland. 9. Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Bern, Switzerland. 10. Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland. 11. Institute of Radiology, Luzerner Kantonsspital, Luzern 16, Switzerland. 12. Department of Radiology, Geneva University Hospital, Genève, Switzerland. 13. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistr. 100, CH-8091, Zurich, Switzerland. hatem.alkadhi@usz.ch.
Abstract
OBJECTIVES: To identify imaging algorithms and indications, CT protocols, and radiation doses in polytrauma patients in Swiss trauma centres. METHODS: An online survey with multiple choice questions and free-text responses was sent to authorized level-I trauma centres in Switzerland. RESULTS: All centres responded and indicated that they have internal standardized imaging algorithms for polytrauma patients. Nine of 12 centres (75 %) perform whole-body CT (WBCT) after focused assessment with sonography for trauma (FAST) and conventional radiography; 3/12 (25 %) use WBCT for initial imaging. Indications for WBCT were similar across centres being based on trauma mechanisms, vital signs, and presence of multiple injuries. Seven of 12 centres (58 %) perform an arterial and venous phase of the abdomen in split-bolus technique. Six of 12 centres (50 %) use multiphase protocols of the head (n = 3) and abdomen (n = 4), whereas 6/12 (50 %) use single-phase protocols for WBCT. Arm position was on the patient`s body during scanning (3/12, 25 %), alongside the body (2/12, 17 %), above the head (2/12, 17 %), or was changed during scanning (5/12, 42 %). Radiation doses showed large variations across centres ranging from 1268-3988 mGy*cm (DLP) per WBCT. CONCLUSIONS: Imaging algorithms in polytrauma patients are standardized within, but vary across Swiss trauma centres, similar to the individual WBCT protocols, resulting in large variations in associated radiation doses. KEY POINTS: • Swiss trauma centres have internal standardized imaging algorithms for trauma patients • Whole-body CT is most commonly used for imaging of trauma patients • CT protocols and radiation doses vary greatly across Swiss trauma centres.
OBJECTIVES: To identify imaging algorithms and indications, CT protocols, and radiation doses in polytraumapatients in Swiss trauma centres. METHODS: An online survey with multiple choice questions and free-text responses was sent to authorized level-I trauma centres in Switzerland. RESULTS: All centres responded and indicated that they have internal standardized imaging algorithms for polytraumapatients. Nine of 12 centres (75 %) perform whole-body CT (WBCT) after focused assessment with sonography for trauma (FAST) and conventional radiography; 3/12 (25 %) use WBCT for initial imaging. Indications for WBCT were similar across centres being based on trauma mechanisms, vital signs, and presence of multiple injuries. Seven of 12 centres (58 %) perform an arterial and venous phase of the abdomen in split-bolus technique. Six of 12 centres (50 %) use multiphase protocols of the head (n = 3) and abdomen (n = 4), whereas 6/12 (50 %) use single-phase protocols for WBCT. Arm position was on the patient`s body during scanning (3/12, 25 %), alongside the body (2/12, 17 %), above the head (2/12, 17 %), or was changed during scanning (5/12, 42 %). Radiation doses showed large variations across centres ranging from 1268-3988 mGy*cm (DLP) per WBCT. CONCLUSIONS: Imaging algorithms in polytraumapatients are standardized within, but vary across Swiss trauma centres, similar to the individual WBCT protocols, resulting in large variations in associated radiation doses. KEY POINTS: • Swiss trauma centres have internal standardized imaging algorithms for traumapatients • Whole-body CT is most commonly used for imaging of traumapatients • CT protocols and radiation doses vary greatly across Swiss trauma centres.
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