Optimization of CT protocol for imaging of polytraumatized patients

Background: The aim of the study was to reduce the radiation dose to patients undergoing whole-body computed tomography (CT) for multiple trauma, while maintaining a good image quality.
Material/Methods: The study was conducted between January 2008 and November 2009. All examinations were performed on a 16-row scanner. The CT protocol comprised native scans of the head and spine and contrast-enhanced scans of the chest and abdomen. Modifications to an original protocol (protocol 1, 101 patients) included modifying the mode of contrast injection (protocol 2, 130 patients) and decreasing the beam energy (protocols 3 and 4, 32 and 64 patients, respectively).
Results: Changing the mode of injection resulted in 24% reduction of dose length product (DLP) for scanning the body. Reducing the beam energy to 100 kVP allowed significant reduction in total DLP (41%); however, the quality of cervical spine images was unsatisfactory. The final protocol, in which the neurocranium was scanned with 100 kVp, the skull base and cervical spine with 120 kVp, and the body with 100 kVp, also reduced the dose significantly (by 30%), while preserving a good quality of diagnostic images.
Conclusions: Current solutions in scanner technology and injection technique provide a large field for protocol optimization, and scanning with relatively low doses is achievable without deterioration of image quality.

Keywords: whole-body CT, polytrauma, radiation dose