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Radiation Dose Levels in Pediatric Skeletal Survey for Suspected Child Abuse: A Preliminary Study

H Khosravi1,2*, A Fatemi1 , C Gordon2 , (1) University of Mississippi Medical Center,Jackson, MS(2) McMaster university Medical Center, Hamilton, ON


(Wednesday, 8/1/2018) 9:30 AM - 10:00 AM

Room: Exhibit Hall | Forum 8

Purpose: To evaluate the range of entrance doses associated with skeletal surveys in child suspected abuse and to identify which of the views account for the greatest dose burden in two major healthcare providers.

Methods: An audit of skeletal surveys over one year period was performed by accessing the Radiation Dose Structured Report (RDSR). Cases were acquired on GE Discovery XR656 Digital Radiographic System at Hamilton Health Sciences Corporation(HHSC),and University of Mississippi Medical Center(UMMC); some techniques were manual at HHSC but other were ‘photo timed’.For each of the 20-25 views comprising the Skeletal Survey the Entrance Skin Air KERMA (ESAK) & Dose Area Product (DAP) was recorded and were normalized to the patient entrance surface. Minimum, maximum, median and average ESAK & DAP were calculated for the audit sample.

Results: The average age of patients sampled, in 3 sub-sets (<1year,1-1.5years and =>1.5<10 Years) was 60,21 and 19 percent, respectively. The total ESAK for same age categories were 2.1, 2.3 and 2.8 mGy, respectively. In each patient sub-set a variety of views are done. It was concluded that those of the trunk account for ~%70 of the total dose burden. Of the trunk views, by far those of the Lumbar spine[AP & Lateral] impart the largest dose. The DRL were 2.07 and 1.48 mGy for total body and trunk, respectively. This abstract is based on data acquired at HHSC, the full study will be completed at UMMC.

Conclusion: The total dose increases with age. Since torso view account for ~%70 of total dose, consideration should be given to optimizing these views first, to ensure optimal patient compliance. Clinical Application: This study will define Diagnostic Reference Levels (DRL) for skeletal surveys in two different healthcare systems. The DRL’s will be established for age categories which is a guidance for patient entrance exposures.


Not Applicable / None Entered.


IM- X-ray: Radiation dosimetry & risk

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