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Radiation doses in diagnostic imaging for suspected physical abuse
  1. Raylene Rao1,
  2. Diana Browne2,
  3. Brian Lunt2,3,
  4. David Perry2,
  5. Peter Reed4,
  6. Patrick Kelly1,5
  1. 1 Te Puaruruhau (Child Protection Team), Starship Children’s Health, Auckland, New Zealand
  2. 2 Department of Paediatric Radiology, Starship Children’s Health, Auckland, New Zealand
  3. 3 Auckland City Hospital, Department of Nuclear Medicine, Auckland, New Zealand
  4. 4 Children’s Research Centre, Starship Children’s Health, Auckland, New Zealand
  5. 5 Department of Paediatrics: Child and Youth Health, University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
  1. Correspondence to Patrick Kelly, Te Puaruruhau (Child Protection Team), Starship Children’s Health, Auckland, New Zealand; patrickk{at}adhb.govt.nz

Abstract

Objective To measure the actual radiation dose delivered by imaging techniques commonly used in the radiography of suspected physical abuse and to make this information available to health professionals and families.

Methods Data were collected retrospectively on children under 3 years referred for skeletal surveys for suspected physical abuse, non-contrast CT head scan or radionuclide imaging of the bones in Starship Children’s Hospital, Auckland, New Zealand from January to December 2015. Patient size-specific conversion coefficients were derived from International Commission on Radiologic Protection tissue weighting factors and used to calculate effective dose.

Results Seventy-one patients underwent an initial skeletal survey, receiving a mean effective dose of 0.20 mSv (95% CI 0.18 to 0.22). Sixteen patients had a follow-up survey with a mean effective dose of 0.10 mSv (95% CI 0.08 to 0.11). Eighty patients underwent CT head which delivered a mean effective dose of 2.49 mSv (95% CI 2.37 to 2.60). Thirty-nine patients underwent radionuclide bone imaging which delivered a mean effective dose of 2.27 mSv (95% CI 2.11 to 2.43).

Conclusions In a paediatric centre, skeletal surveys deliver a relatively low effective radiation dose, equivalent to approximately 1 month of background radiation. Non-contrast CT head scan and radionuclide bone imaging deliver similar doses, equivalent to approximately 1 year of background radiation. This information should be considered when gaining informed consent and incorporated in patient education handouts.

  • physical abuse
  • radiography
  • radionuclide imaging
  • patient education handout
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Footnotes

  • Contributors PK conceptualised the study, reviewed the study protocol and data, revised the manuscript and approved the final manuscript as submitted. RR drafted the study protocol, collected data, coordinated data collection, performed initial data analysis, drafted the manuscript and approved the final manuscript as submitted. BL collected and performed conversion of data, reviewed the manuscript and approved the final manuscript as submitted. DB helped to conceptualise the study, coordinated and supervised data collection, reviewed the manuscript and approved the final manuscript as submitted. DP helped to conceptualise the study, reviewed the manuscript and approved the final manuscript as submitted. PR performed statistical analysis of the data, reviewed the manuscript and approved the final manuscript as submitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Anonymised data concerning radiation dose may be shared upon request from the corresponding author (ORCID 0000-0002-8813-8877). A data sharing agreement will be generated, and all data will be anonymised prior to sharing.

  • Patient consent for publication Not required.

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