Edel Doyle1, Matthew R Dimmock2,3, Kam L Lee4, Peter Thomas4, Richard B Bassed5,6. 1. Department of Forensic Medicine, Monash University, 65 Kavanagh Street, Melbourne, Southbank, VIC, 3006, Australia. edel.doyle@monash.edu. 2. Medical Imaging and Radiation Sciences, Monash University, Melbourne, Australia. 3. School of Allied Health Professions, Keele University, Staffordshire, UK. 4. Australian Radiation Protection and Nuclear Safety Agency, Yallambie, VIC, Australia. 5. Department of Forensic Medicine, Monash University, 65 Kavanagh Street, Melbourne, Southbank, VIC, 3006, Australia. 6. Academic Programs, Victorian Institute of Forensic Medicine, Melbourne, VIC, Australia.
Abstract
BACKGROUND: A series of 31 radiographs is recommended by the Royal College of Radiologists (RCR) when investigating suspected physical abuse (SPA). OBJECTIVE: To determine the radiation dose delivered for skeletal surveys performed for SPA in Victorian radiology departments based on their local protocols. MATERIALS AND METHODS: A 5-year-old paediatric bone fracture phantom was radiographed at five radiology sites using both the RCR recommended protocol and, where applicable, the local departmental SPA protocol. The radiation doses were measured and recorded. These were scaled down to estimate the effective radiation doses for a 2-year-old child at each site and the associated radiation risks estimated. RESULTS: The median effective dose for all radiographic projections in the RCR skeletal survey radiographic series was 0.09 mSv. The estimated risk of radiation-induced cancer and radiation-induced death from cancer for 2-year-old children is classified as "very low," with girls having a higher risk than boys. CONCLUSION: The median effective radiation dose for the RCR skeletal survey for imaging in SPA was 0.09 mSv resulting in a "very low" additional risk of radiation-induced cancer. The authors will now aim to ascertain whether whole-body CT skeletal survey can replace the radiographic series for imaging in SPA while maintaining a comparable radiation dose.
BACKGROUND: A series of 31 radiographs is recommended by the Royal College of Radiologists (RCR) when investigating suspected physical abuse (SPA). OBJECTIVE: To determine the radiation dose delivered for skeletal surveys performed for SPA in Victorian radiology departments based on their local protocols. MATERIALS AND METHODS: A 5-year-old paediatric bone fracture phantom was radiographed at five radiology sites using both the RCR recommended protocol and, where applicable, the local departmental SPA protocol. The radiation doses were measured and recorded. These were scaled down to estimate the effective radiation doses for a 2-year-old child at each site and the associated radiation risks estimated. RESULTS: The median effective dose for all radiographic projections in the RCR skeletal survey radiographic series was 0.09 mSv. The estimated risk of radiation-induced cancer and radiation-induced death from cancer for 2-year-old children is classified as "very low," with girls having a higher risk than boys. CONCLUSION: The median effective radiation dose for the RCR skeletal survey for imaging in SPA was 0.09 mSv resulting in a "very low" additional risk of radiation-induced cancer. The authors will now aim to ascertain whether whole-body CT skeletal survey can replace the radiographic series for imaging in SPA while maintaining a comparable radiation dose.
Authors: Leonie Segal; James Doidge; Jason M Armfield; Emmanuel S Gnanamanickam; David B Preen; Derek S Brown; Ha Nguyen Journal: JAMA Netw Open Date: 2021-06-01