Room: AAPM ePoster Library
To survey the exposure parameters associated with osseous survey studies in child suspected abuse and to identify which of the views account for the greatest dose burden and establish the diagnostic reference level in the state of Mississippi.
An audit of osseous surveys over 3 year’s period were performed by accessing the patients dose data. 524 cases were acquired in pediatric radiology department of University of Mississippi Medical Center (UMMC); For each of the 20-25 views comprising the Osseous Survey studies the Entrance Skin Air KERMA (ESAK) & Dose Area Product (DAP) were recorded and were normalized to the patient entrance surface. Minimum, maximum, median and average ESAK & DAP were calculated for all of the cases.
The average age of patients were categorized in 6 sub-sets of 0.5 years to 3 years-old were %44,%36, %10,%5, %3 and %2 of total patients, respectively. The total number of 11233 views were evaluated. In each patients sub-set a variety of views were done and the average number of events was 23.35 for each patient. The total ESAK for same age categories were 1.37, 1.93, 2.40, 2.59, 3.63 and 3.21 mGy, respectively. It was concluded that those of the trunk account for %22 of the total dose burden (0.56/2.54 mGy). On the trunk views, by far those of the Lumbar, Thoracic spines [AP-Lateral] views impart the largest dose. The DRL were 2.44 and 0.606 mGy for total body and trunk, respectively.
The total dose increases with age. Torso views account for ~%22 of total dose, due to fewer torso views in UMMC, consideration should be given to optimizing the total number of views first, to ensure optimal patient compliance. Clinical Application: This study has defined Diagnostic Reference Levels (DRL) for osseous surveys in the major healthcare provider in Mississippi.