Study seeks to set guidelines for reducing computerized tomography (CT) imaging for intra-abdominal injuries

A federal grant of more than $400,000 has been approved for a multi-center study, coordinated through the Department of Emergency Medicine, that will seek to develop guidelines for the use of computerized tomography imaging in diagnosing intra-abdominal injuries in children.

Jim Holmes, associate professor of emergency medicine, applied for the grant from the Centers for Disease Control, which approved $431,310 in funds. The study, to be conducted at several medical centers around the country, will be conducted through the Pediatric Emergency Care Applied Research Network (PECARN).

CT scans of the abdomen are routinely and liberally performed in the evaluation of blunt trauma, especially in children. Overuse of this procedure increases the cost of care, reduces efficiency and potentially increases the risks associated with radiation exposure.

The study seeks to develop a safe and reliable means for reducing the use of CT scans while not jeopardizing the early identification of significant intra-abdominal injuries. Trauma is the leading cause of death in children, and intra-abdominal injuries are a frequent cause of morbidity and mortality due to trauma.

Some intra-abdominal injuries are difficult to identify, and failure to do so results in preventable morbidity and mortality. Abdominal computerized tomography is the reference standard for the diagnosis of intra-abdominal injury. However, CT scanning presents serious risks, mainly that of radiation-induced cancer.

For every 1,500 children undergoing abdominal CT scanning, approximately one child will die from a cancer induced by the radiation, and up to three children will develop non-fatal cancers from this exposure.