title: Radiation exposure in whole-body computed tomography of multiple trauma patients: bearing devices and patient positioning.
abstract: BACKGROUND
  Whole-body computed tomography (WBCT) plays an important role in the management of severely injured patients. We evaluated the radiation exposure of WBCT scans using different positioning boards and arm positions.
  
  
  METHODS
  In this retrospective study, the radiation exposure of WBCT using a 16-slice multislice computed tomography scanner was evaluated. Individual effective doses (E, mSV) was calculated. Patients were assigned to two groups according to placement on a plastic transfer mat (PTM, group 1) or on the Trauma Transfer™-Board (TTB, group 2). Data were collected for each group with arm placement on the abdomen (a) or in raising position (b), respectively. The maximum ventro-dorsal diameter [VDD] at the trunk was measured.
  
  
  RESULTS
  100 patients with potentially life-threatening injuries were analysed. Patient demographics and VDD did not differ in the two groups. Radiation exposure in term of E did not reveal any significant differences between the two positioning boards using same arm position [group 1a (n=26) vs. 2a (n=24) (mSV): 16.7±4.7 vs. 17.1±4.4, group 1b (n=26) vs. 2b (n=24) (mSV): 13.1±3.9 vs. 14.3±1.5]. The arm raising positioning showed a significant reduction in E in comparison to the placement on abdomen position [group 1b vs. 1a (mSV): 13.1±3.9 vs. 16.7±4.7, p<0.05, group 2b vs. 2a (mSV): 14.3±1.5 vs. 17.1±4.4, p<0.05].
  
  
  CONCLUSIONS
  Patient arm positioning for WBCT has an important influence on radiation exposure. Effective dose was 16-22% lower when arms were raised. An individual placement algorithm may lead to a relevant reduction of radiation exposure of severely injured patients.
authors: Center of Radiology, Department of Diagnostic and Interventional Radiology and Neuroradiology, Hospital of Fulda, Pacelliallee 4, D-3604 Fulda, Germany. bjoern.loewenhardt@web.de
authors: Björn
authors: B
authors: Loewenhardt
authors: Michael
authors: M
authors: Buhl
authors: André
authors: A
authors: Gries
authors: Clemens-Alexander
authors: CA
authors: Greim
authors: Achim
authors: A
authors: Hellinger
authors: Martin
authors: M
authors: Hessmann
authors: Thomas
authors: T
authors: Rathjen
authors: Michael
authors: M
authors: Reinert
authors: Christoph
authors: C
authors: Manke
authors: Michael
authors: M
authors: Bernhard
mesh_terms: D001132:Arm / Q000000981:diagnostic imaging; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D009104:Multiple Trauma / Q000000981:diagnostic imaging*; D056888:Patient Positioning; D011829:Radiation Dosage; D011860:Radiography, Abdominal / Q000379:methods*; D011874:Radiometry; D012189:Retrospective Studies; D051598:Whole Body Imaging / Q000379:methods*