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Arch Dis Child. 2019 Sep;104(9):863-868. doi: 10.1136/archdischild-2018-316286. Epub 2019 Apr 17.

Radiation doses in diagnostic imaging for suspected physical abuse.

Author information

1
Te Puaruruhau (Child Protection Team), Starship Children's Health, Auckland, New Zealand.
2
Department of Paediatric Radiology, Starship Children's Health, Auckland, New Zealand.
3
Auckland City Hospital, Department of Nuclear Medicine, Auckland, New Zealand.
4
Children's Research Centre, Starship Children's Health, Auckland, New Zealand.
5
Department of Paediatrics: Child and Youth Health, University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand.

Abstract

OBJECTIVE:

To measure the actual radiation dose delivered by imaging techniques commonly used in the radiography of suspected physical abuse and to make this information available to health professionals and families.

METHODS:

Data were collected retrospectively on children under 3 years referred for skeletal surveys for suspected physical abuse, non-contrast CT head scan or radionuclide imaging of the bones in Starship Children's Hospital, Auckland, New Zealand from January to December 2015. Patient size-specific conversion coefficients were derived from International Commission on Radiologic Protection tissue weighting factors and used to calculate effective dose.

RESULTS:

Seventy-one patients underwent an initial skeletal survey, receiving a mean effective dose of 0.20 mSv (95% CI 0.18 to 0.22). Sixteen patients had a follow-up survey with a mean effective dose of 0.10 mSv (95% CI 0.08 to 0.11). Eighty patients underwent CT head which delivered a mean effective dose of 2.49 mSv (95% CI 2.37 to 2.60). Thirty-nine patients underwent radionuclide bone imaging which delivered a mean effective dose of 2.27 mSv (95% CI 2.11 to 2.43).

CONCLUSIONS:

In a paediatric centre, skeletal surveys deliver a relatively low effective radiation dose, equivalent to approximately 1 month of background radiation. Non-contrast CT head scan and radionuclide bone imaging deliver similar doses, equivalent to approximately 1 year of background radiation. This information should be considered when gaining informed consent and incorporated in patient education handouts.

KEYWORDS:

patient education handout; physical abuse; radiography; radionuclide imaging

Conflict of interest statement

Competing interests: None declared.

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