Radiation exposure - how do CT scans for appendicitis compare between a free standing children's hospital and non-dedicated pediatric facilities?

BackgroundWe compare the amount of radiation children receive from CT scans performed at non-dedicated pediatric facilities (OH) versus those at a dedicated children's hospital (CH).MethodsUsing a retrospective chart review, all children undergoing CT scanning for appendicitis at an OH were compared to children undergoing CT imaging for appendicitis at a CH between January 2011 and November 2012.ResultsOne hundred sixty-three children underwent CT scans at 42 different OH. Body mass index was similar between the two groups (21.00 ± 6.49 kg/m2, 19.58 ± 5.18 kg/m2, P = 0.07). Dose length product (DLP) was 620 ± 540.3 at OH and 253.78 ± 211.08 at CH (P < 0.001). OH CT scans accurately diagnosed appendicitis in 81%, while CT scans at CH were accurate in 95% (P = 0.026). CTDIvol was recorded in 65 patients with subset analysis showing CTDIvol of 16.98 ± 15.58 and 4.89 ± 2.64, a DLP of 586.25 ± 521.59 and 143.54 ± 41.19, and size-specific dose estimate (SSDE) of 26.71 ± 23.1 and 3.81 ± 2.02 at OH and CH, respectively (P < 0.001).ConclusionUsing SSDE as a marker for radiation exposure, children received 86% less radiation and had improved diagnostic accuracy when CT scans are performed at a CH.