title: Cumulative effective dose associated with radiography and CT of adolescents with spinal injuries.
abstract: OBJECTIVE
  The purpose of this study was to analyze the quantity and distribution of cumulative effective doses in diagnostic imaging of adolescents with spinal injuries.
  
  
  METHODS
  At a level 1 trauma center from July 2003 through June 2009, imaging procedures during initial evaluation and hospitalization and after discharge of all patients 10-20 years old with spinal fractures were retrospectively analyzed. The cumulative effective doses for all imaging studies were calculated, and the doses to patients with spinal injuries who had multiple traumatic injuries were compared with the doses to patients with spinal injuries but without multiple injuries. The significance level was set at 5%.
  
  
  RESULTS
  Imaging studies of 72 patients (32 with multiple injuries; average age, 17.5 years) entailed a median cumulative effective dose of 18.89 mSv. Patients with multiple injuries had a significantly higher total cumulative effective dose (29.70 versus 10.86 mSv, p < 0.001) mainly owing to the significantly higher CT-related cumulative effective dose to multiple injury patients during the initial evaluation (18.39 versus 2.83 mSv, p < 0.001). Overall, CT accounted for 86% of the total cumulative effective dose.
  
  
  CONCLUSIONS
  Adolescents with spinal injuries receive a cumulative effective dose equal to that of adult trauma patients and nearly three times that of pediatric trauma patients. Areas of focus in lowering cumulative effective dose should be appropriate initial estimation of trauma severity and careful selection of CT scan parameters.
authors.affiliation: Institute of Diagnostic Radiology, Interventional Radiology and Nuclear Medicine, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Ruhr-University of Bochum, Buerkle-de-la-Camp Platz 1, D-44789 Bochum, Germany.
authors.forename: Stefan P
authors.initials: SP
authors.lastname: Lemburg
authors.forename: Soeren A
authors.initials: SA
authors.lastname: Peters
authors.forename: Daniela
authors.initials: D
authors.lastname: Roggenland
authors.forename: Volkmar
authors.initials: V
authors.lastname: Nicolas
authors.forename: Christoph M
authors.initials: CM
authors.lastname: Heyer
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D011829:Radiation Dosage; D011874:Radiometry / Q000379:methods; D012189:Retrospective Studies; D013124:Spinal Injuries / Q000000981:diagnostic imaging*; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult