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Abstract

Background
Whole-body computed tomography (WBCT) is the preferred first line investigation for patients with suspected multiple traumas. To decrease the potential for increased spinal injury, bearing devices, including trauma mattress, are recommended for adequate spine immobilisation. This study assesses the effect of trauma mattress on the dose and image quality of WBCT examinations.

Methods
This was a phantom-based experimental study. Two different paediatric whole-body anthropomorphic phantoms from Kyoto Kagaku were used: newborn (PBU-80) and 5-year-old (PBU-70). Optimised WBCT protocols were scanned with and without a trauma mattress. The effective dose (ED) from each protocol was estimated from CT-Expo software and from the product of the dose length product and dose conversion coefficient (DLP-E(k)) methods, while image quality was assessed subjectively and objectively.

Results
The use of trauma mattress increased the mean ED and decreased the SNR of the 5-year-old phantom examinations by 7.0% (p = 0.776) and 21.4% (p = 0.194) respectively. In contrast, there was a 43.9% increase in ED (p = 0.019) and a 16.5% decrease in SNR (p = 0.221) when trauma mattress was used for the newborn phantom examinations. The differences in the mean ED from CT-Expo and the DLP-E (k) were not statistically significant (p = 0.258 and 0.278 for newborn and 5-year-old phantoms, respectively). The median organ doses estimated from all examinations performed without a trauma mattress were significantly lower than examinations performed with a trauma mattress (p = 0.001). The use of the trauma mattress increased the average tube voltage, tube current, volume computed tomography dose index (CTDIvol), and the dose-length product (DLP) by 1.3%, 63.9%, 48.3%, and 47.3%, respectively. However, a significant increase was only observed in the tube current (p = 0.014).

Conclusion
The use of trauma mattress increased the ED and decreased the SNR during the WBCT examinations, albeit at different levels for the newborn and 5-year-old phantoms. Consequently, medical imaging professionals should restrict the use of bearing devices to examinations that justifiably require them. Appropriate adjustments in scan protocols for different body habitus and the use of alternative immobilisation techniques, where necessary, will further enhance patient safety during paediatric WBCT examinations.

Publication Type:	Article
Additional Information:	This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Publisher Keywords:	Whole-body computed tomography, Trauma mattress, Immobilising devices, Bearing devices, Anthropomorphic Phantom, Dose optimisation
Subjects:	Q Science > QA Mathematics > QA75 Electronic computers. Computer science R Medicine > RC Internal medicine
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Midwifery & Radiography
SWORD Depositor:	Symplectic Administrator

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