Optimizing Radiation Exposure in Paediatric Trauma Imaging: Balancing Safety and Diagnostic Accuracy

Abstract

Background: The challenge in paediatric trauma imaging is to minimize radiation exposure while maintaining diagnostic accuracy.
Purpose: To evaluate the impact of a bundled radiation optimization protocol in a tertiary paediatric trauma center, focusing on radiation dose reduction and diagnostic outcomes.
Methods: In this prospective audit, 420 trauma imaging encounters (210 pre-intervention, 210 post-intervention) were analyzed. The protocol included revised guidelines, increased use of ultrasound, low-dose CT, and clinician education. Primary outcomes were mean effective dose and imaging modality use; secondary outcomes included missed injuries and repeat imaging.
Results: Mean effective dose per encounter declined from 5.84 ± 2.35 mSv (pre) to 2.34 ± 0.94 mSv (post, p<0.001). CT use dropped from 46% to 32%; ultrasound use rose from 19% to 33%. No significant difference was seen in missed injury rates (pre: 0.95%, post: 1.43%, p=0.65) or repeat imaging.
Conclusion: A multidisciplinary radiation optimization protocol can significantly reduce radiation exposure in paediatric trauma imaging without compromising diagnostic accuracy.