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European Radiology

, Volume 27, Issue 5, pp 1922–1928 | Cite as

Imaging algorithms and CT protocols in trauma patients: survey of Swiss emergency centers

  • R. Hinzpeter
  • T. Boehm
  • D. Boll
  • C. Constantin
  • F. Del Grande
  • V. Fretz
  • S. Leschka
  • T. Ohletz
  • M. Brönnimann
  • S. Schmidt
  • T. Treumann
  • P.-A. Poletti
  • Hatem Alkadhi
Emergency Radiology

Abstract

Objectives

To identify imaging algorithms and indications, CT protocols, and radiation doses in polytrauma patients in Swiss trauma centres.

Methods

An online survey with multiple choice questions and free-text responses was sent to authorized level-I trauma centres in Switzerland.

Results

All centres responded and indicated that they have internal standardized imaging algorithms for polytrauma patients. Nine of 12 centres (75 %) perform whole-body CT (WBCT) after focused assessment with sonography for trauma (FAST) and conventional radiography; 3/12 (25 %) use WBCT for initial imaging. Indications for WBCT were similar across centres being based on trauma mechanisms, vital signs, and presence of multiple injuries. Seven of 12 centres (58 %) perform an arterial and venous phase of the abdomen in split-bolus technique. Six of 12 centres (50 %) use multiphase protocols of the head (n = 3) and abdomen (n = 4), whereas 6/12 (50 %) use single-phase protocols for WBCT. Arm position was on the patient`s body during scanning (3/12, 25 %), alongside the body (2/12, 17 %), above the head (2/12, 17 %), or was changed during scanning (5/12, 42 %). Radiation doses showed large variations across centres ranging from 1268-3988 mGy*cm (DLP) per WBCT.

Conclusions

Imaging algorithms in polytrauma patients are standardized within, but vary across Swiss trauma centres, similar to the individual WBCT protocols, resulting in large variations in associated radiation doses.

Key Points

Swiss trauma centres have internal standardized imaging algorithms for trauma patients

Whole-body CT is most commonly used for imaging of trauma patients

CT protocols and radiation doses vary greatly across Swiss trauma centres

Keywords

Radiation Trauma Computed tomography Algorithm Imaging 

Abbreviations

WBCT

Whole-body computed tomography

FAST

Focused assessment with sonography for trauma

DLP

Dose-length product

Notes

Acknowledgements

The scientific guarantor of this publication is Hatem Alkadhi. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Informed consent was not required because the study represents a national survey, and no patient data were handled for this manuscript. None of the subjects have been previously reported.

Methodology: retrospective, observational, multicenter study.

We would like to thank Dr. Christopher M Smith, author of a survey in the UK, and Dr. Hampus Eklöf, author of a survey in Nordic countries, for providing us their questionnaires. We thank also Dr. Alexandra Platon, Geneva, and Dr. Daniel Ott, Bern, for supporting our project.

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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • R. Hinzpeter
    • 1
  • T. Boehm
    • 2
  • D. Boll
    • 3
  • C. Constantin
    • 4
  • F. Del Grande
    • 5
  • V. Fretz
    • 6
  • S. Leschka
    • 7
  • T. Ohletz
    • 8
  • M. Brönnimann
    • 9
  • S. Schmidt
    • 10
  • T. Treumann
    • 11
  • P.-A. Poletti
    • 12
  • Hatem Alkadhi
    • 1
  1. 1.Institute of Diagnostic and Interventional RadiologyUniversity Hospital ZurichZurichSwitzerland
  2. 2.Department of RadiologyKantonsspital GraubuendenChurSwitzerland
  3. 3.Department of Radiology and Nuclear MedicineUniversity Hospital BaselBaselSwitzerland
  4. 4.Department of RadiologySpital WallisVispSwitzerland
  5. 5.Department of RadiologyOspedale Regionale di LuganoLuganoSwitzerland
  6. 6.Institute of Radiology and Nuclear MedicineKantonsspital WinterthurWinterthurSwitzerland
  7. 7.Division of Radiology and Nuclear MedicineKantonsspital St GallenGallenSwitzerland
  8. 8.Department of RadiologyKantonsspital AarauAarauSwitzerland
  9. 9.Department of Diagnostic, Interventional and Pediatric RadiologyUniversity Hospital BernBernSwitzerland
  10. 10.Department of Diagnostic and Interventional RadiologyLausanne University HospitalLausanneSwitzerland
  11. 11.Institute of RadiologyLuzerner KantonsspitalLuzern 16Switzerland
  12. 12.Department of RadiologyGeneva University HospitalGenèveSwitzerland

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