Patient safety analysis in radiation burden of head computed tomography imaging in 1,185 neurosurgical inpatients

ABSTRACT Objective We performed a retrospective analysis in a cohort of 1,185 patients at our institution who were identified as undergoing one or more head CT exams during their inpatient stay on the neurosurgery service. To quantify the number, type, and associated radiation burden of head CT procedures performed on the neurosurgery service. Material and Methods CT procedure records and radiology reports were obtained via database search and directly validated against records retrieved from manual chart review. Next, dosimetry data from the head CT procedures were extracted via automated text mining of electronic radiology reports. Results Among 4,510 identified adult head CT procedures, 88% were standard head CT exams. 3.65 ± 3.60 head CT scans were performed during an average adult admission. The most common primary diagnoses were neoplasms, trauma, and other hemorrhage. The median cumulative effective dose per admission was 5.66 mSv (range: 1.06 - 84.5 mSv; mean: 8.56 ± 8.95 mSv). The median cumulative effective dose per patient was 6.4 mSv (range: 1.1 – 127 mSv; mean: 9.26 ± 10.0 mSv). Conclusions The median cumulative radiation burden from head CT imaging in our cohort equates roughly to a single chest CT scan, well within accepted limits for safe CT imaging in adults. Refined methods are needed to characterize the safety profile of the minority of pediatric patients identified in our study.