title: Radiation exposure - how do CT scans for appendicitis compare between a free standing children's hospital and non-dedicated pediatric facilities?
abstract: BACKGROUND
  We compare the amount of radiation children receive from CT scans performed at non-dedicated pediatric facilities (OH) versus those at a dedicated children's hospital (CH).
  
  
  METHODS
  Using a retrospective chart review, all children undergoing CT scanning for appendicitis at an OH were compared to children undergoing CT imaging for appendicitis at a CH between January 2011 and November 2012.
  
  
  RESULTS
  One hundred sixty-three children underwent CT scans at 42 different OH. Body mass index was similar between the two groups (21.00±6.49kg/m(2), 19.58±5.18kg/m(2), P=0.07). Dose length product (DLP) was 620±540.3 at OH and 253.78±211.08 at CH (P < 0.001). OH CT scans accurately diagnosed appendicitis in 81%, while CT scans at CH were accurate in 95% (P=0.026). CTDIvol was recorded in 65 patients with subset analysis showing CTDIvol of 16.98±15.58 and 4.89±2.64, a DLP of 586.25±521.59 and 143.54±41.19, and size-specific dose estimate (SSDE) of 26.71±23.1 and 3.81±2.02 at OH and CH, respectively (P<0.001).
  
  
  CONCLUSIONS
  Using SSDE as a marker for radiation exposure, children received 86% less radiation and had improved diagnostic accuracy when CT scans are performed at a CH.
authors.affiliation: Children's Mercy Hospitals and Clinics, Department of Surgery, Kansas City, MO, USA.
authors.forename: Nicole E
authors.initials: NE
authors.lastname: Sharp
authors.affiliation: Children's Mercy Hospitals and Clinics, Department of Surgery, Kansas City, MO, USA.
authors.forename: Maneesha U
authors.initials: MU
authors.lastname: Raghavan
authors.affiliation: Children's Mercy Hospitals and Clinics, Department of Surgery, Kansas City, MO, USA.
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Svetanoff
authors.affiliation: Children's Mercy Hospitals and Clinics, Department of Surgery, Kansas City, MO, USA.
authors.forename: Priscilla T
authors.initials: PT
authors.lastname: Thomas
authors.affiliation: Children's Mercy Hospitals and Clinics, Department of Surgery, Kansas City, MO, USA.
authors.forename: Susan W
authors.initials: SW
authors.lastname: Sharp
authors.affiliation: Children's Mercy Hospitals and Clinics, Department of Radiology, Kansas City, MO, USA.
authors.forename: James C
authors.initials: JC
authors.lastname: Brown
authors.affiliation: Children's Mercy Hospitals and Clinics, Department of Radiology, Kansas City, MO, USA.
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Rivard
authors.affiliation: Children's Mercy Hospitals and Clinics, Department of Surgery, Kansas City, MO, USA.
authors.forename: Shawn D
authors.initials: SD
authors.lastname: St Peter
authors.affiliation: Children's Mercy Hospitals and Clinics, Department of Surgery, Kansas City, MO, USA. Electronic address: gholcomb@cmh.edu.
authors.forename: George W
authors.initials: GW
authors.lastname: Holcomb
mesh_terms: D000293:Adolescent; D001064:Appendicitis / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D011829:Radiation Dosage; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Appendicitis; Computed tomography (CT); Pediatric; Radiation exposure