Effects of trauma mattress on dose and image quality of paediatric whole-body computed tomography examinations

Background Whole-body computed tomography (WBCT) is the preferred first line investigation for patients with suspected multiple traumas. To decrease the potential for increased spinal injury, it is recommended that bearing devices, such as trauma mattress, be used to ensure adequate immobilisation of the spine. This study assessed the effect of the use of trauma mattress on the dose and image quality of WBCT examinations. Methods This was a phantom-based experimental study. Two different paediatric whole-body anthropomorphic phantoms from Kyoto Kagaku were used: newborn (PBU-80) and 5-year-old (PBU-70). Different WBCT protocols were scanned with and without trauma mattress. The effective dose (ED) from each protocol was estimated from CT-Expo software and from the product of the dose length product and dose conversion coefficient (DLP-E(k)) method, while image quality was assessed both subjectively and objectively. Results The use of trauma mattress increased the mean ED and decreased the SNR of paediatric examinations by 7.03% ( p  = 0.776) and 21.37% ( p  = 0.194) respectively. Similarly, there was a 43.87% increase in ED ( p  = 0.019) and a 16.5% decrease in SNR ( p  = 0.221) when trauma mattress was used for newborn examinations. The differences in the mean ED from CT-Expo and the DLP-E (k) were not statistically significant (p = 0.258 and 0.278 for newborn and paediatric phantoms respectively). The use of the trauma mattress increased the average tube voltage, tube current, dose-length product (DLP), and the volume computed tomography dose index (CTDI _vol ) by 1.33%, 63.91%. 47.28%, and 48.34% respectively. Conclusion The use of trauma mattress increased the ED and decreased the SNR during the WBCT examinations, albeit at different levels for the newborn and 5-year-old phantoms. Radiologists and radiographers should critically evaluate patients’ conditions and the diagnostic information required to justify the use of bearing devices.