Whole-body computed tomography in trauma patients: optimization of the patient scanning position significantly shortens examination time while maintaining diagnostic image quality

• Main Authors: Hickethier T, Mammadov K, Baeßler B, Lichtenstein T, Hinkelbein J, Smith L, Plum PS, Chon SH, Maintz D, Chang DH
• Format: Article
• Language: English
• Published: Dove Medical Press 2018-05-01
• Series: Therapeutics and Clinical Risk Management
• Subjects: Whole body computed tomography; trauma; positioning; time requirement; image quality
• Online Access: https://www.dovepress.com/whole-body-computed-tomography-in-trauma-patients-optimization-of-the--peer-reviewed-article-TCRM

Tilman Hickethier,1,* Kamal Mammadov,1,* Bettina Baeßler,1 Thorsten Lichtenstein,1 Jochen Hinkelbein,2 Lucy Smith,3 Patrick Sven Plum,4 Seung-Hun Chon,4 David Maintz,1 De-Hua Chang1 1Department of Radiology, University Hospital of Cologne, Cologne, Germany; 2Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany; 3Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Canada; 4Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany *These authors contributed equally to this work Background: The study was conducted to compare examination time and artifact vulnerability of whole-body computed tomographies (wbCTs) for trauma patients using conventional or optimized patient positioning. Patients and methods: Examination time was measured in 100 patients scanned with conventional protocol (Group A: arms positioned alongside the body for head and neck imaging and over the head for trunk imaging) and 100 patients scanned with optimized protocol (Group B: arms flexed on a chest pillow without repositioning). Additionally, influence of two different scanning protocols on image quality in the most relevant body regions was assessed by two blinded readers. Results: Total wbCT duration was about 35% or 3:46 min shorter in B than in A. Artifacts in aorta (27 vs 6%), liver (40 vs 8%) and spleen (27 vs 5%) occurred significantly more often in B than in A. No incident of non-diagnostic image quality was reported, and no significant differences for lungs and spine were found. Conclusion: An optimized wbCT positioning protocol for trauma patients allows a significant reduction of examination time while still maintaining diagnostic image quality. Keywords: CT scan, polytrauma, acute care, time requirement, positioning