• Rosemary Nabaweesi, Raghu H Ramakrishnaiah, Mary E Aitken, Mallikarjuna R Rettiganti, Chunqiao Luo, Robert T Maxson, Charles M Glasier, Phillip J Kenney, and James M Robbins.
• Department of Pediatrics, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas; Arkansas Children's Research Institute, Little Rock, Arkansas. Electronic address: rnabaweesi@uams.edu.
• J Am Coll Radiol. 2018 Jan 1; 15 (1 Pt A): 58-64.

BackgroundUse of cranial CT scans in children has been increasing, in part due to increased awareness of sports-related concussions. CT is the largest contributor to medical radiation exposure, a risk factor for cancer. Long-term cancer risks of CT scans can be two to three times higher for children than for adults because children are more radiosensitive and have a longer lifetime in which to accumulate exposure from multiple scans.Study AimTo compare the radiation exposure injured children receive when imaged at nonpediatric hospitals (NPHs) versus pediatric hospitals.MethodsInjured children younger than 18 years who received a CT scan at a referring hospital during calendar years (CYs) 2010 and 2013 were included. Patient-level factors included demographics, mode of transportation, and Injury Severity Score, and hospital-level factors included region of state, radiology services, and hospital type and size. Our primary outcome of interest was the effective radiation dose.ResultsFour hundred eighty-seven children were transferred to the pediatric trauma center during CYs 2010 and 2013, with a median age of 7.2 years (interquartile range 5-13). The median effective radiation dose received at NPHs was twice that received at the pediatric trauma center (3.8 versus 1.6 mSv, P < .001). Results were confirmed in independent and paired analyses, after controlling for mode of transportation, emergency department disposition, level of injury severity, and at the NPH trauma center level, hospital type, size, region, and radiology services location.ConclusionNPHs have the potential to substantially reduce the medical radiation received by injured children. Pediatric CT protocols should be considered.Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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