title: Whole-body CT-based imaging algorithm for multiple trauma patients: radiation dose and time to diagnosis.
abstract: OBJECTIVE
  To determine the number of imaging examinations, radiation dose and the time to complete trauma-related imaging in multiple trauma patients before and after introduction of whole-body CT (WBCT) into early trauma care.
  
  
  METHODS
  120 consecutive patients before and 120 patients after introduction of WBCT into the trauma algorithm of the University Hospital Zurich were compared regarding the number and type of CT, radiography, focused assessment with sonography for trauma (FAST), additional CT examinations (defined as CT of the same body regions after radiography and/or FAST) and the time to complete trauma-related imaging.
  
  
  RESULTS
  In the WBCT cohort, significantly more patients underwent CT of the head, neck, chest and abdomen (p < 0.001) than in the non-WBCT cohort, whereas the number of radiographic examinations of the cervical spine, chest and pelvis and of FAST examinations were significantly lower (p < 0.001). There were no significant differences between cohorts regarding the number of radiographic examinations of the upper (p = 0.56) and lower extremities (p = 0.30). We found significantly higher effective doses in the WBCT (29.5 mSv) than in the non-WBCT cohort (15.9 mSv; p < 0.001), but fewer additional CT examinations for completing the work-up were needed in the WBCT cohort (p < 0.001). The time to complete trauma-related imaging was significantly shorter in the WBCT (12 min) than in the non-WBCT cohort (75 min; p < 0.001).
  
  
  CONCLUSIONS
  Including WBCT in the initial work-up of trauma patients results in higher radiation doses, but fewer additional CT examinations are needed, and the time for completing trauma-related imaging is shorter.
  
  
  CONCLUSIONS
  WBCT in trauma patients is associated with a high radiation dose of 29.5 mSv.
authors.affiliation: 1 Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Gordic
authors.forename: H
authors.initials: H
authors.lastname: Alkadhi
authors.forename: S
authors.initials: S
authors.lastname: Hodel
authors.forename: H-P
authors.initials: HP
authors.lastname: Simmen
authors.forename: M
authors.initials: M
authors.lastname: Brueesch
authors.forename: T
authors.initials: T
authors.lastname: Frauenfelder
authors.forename: G
authors.initials: G
authors.lastname: Wanner
authors.forename: K
authors.initials: K
authors.lastname: Sprengel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D051598:Whole Body Imaging / Q000379:methods*; D055815:Young Adult