Ultra-low dose CT for suspected physical abuse

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dc.check.date46418
dc.check.infoAccess to this article is restricted until 12 months after publication by request of the publisher
dc.contributor.authorMohammed, Ahmeden
dc.contributor.authorMahon, Eimearen
dc.contributor.authorMoore, Niamhen
dc.contributor.authorSweetman, Lornaen
dc.contributor.authorMurphy, Mary J.en
dc.contributor.authorBeagan, Louiseen
dc.contributor.authorMaher, Michael M.en
dc.contributor.authorEngland, Andrewen
dc.contributor.authorPrecht, H.en
dc.contributor.authorMcEntee, Mark F.en
dc.contributor.funderEuropean Federation of Radiographer Societiesen
dc.contributor.funderEuropean Society of Radiologyen
dc.contributor.funderEFRS Research Huben
dc.date.accessioned2025-12-12T11:28:39Z
dc.date.available2025-12-12T11:28:39Z
dc.date.issued2026-01-31en
dc.description.abstractIntroduction Ultra-low dose CT (ULDCT) of the whole-body is a promising technique to replace radiography for the diagnosis of suspected physical abuse (SPA). This study aims to compare the image quality and radiation dose of ULDCT to standard dose CT (STDCT) in cases of SPA. Methods In this phantom-based study, two sets of newborn, whole-body, anthropomorphic phantom images were acquired using STDCT and ULDCT protocols on a GE Revolution Apex scanner with Deep Learning Iterative Reconstruction (DLIR). The effective dose (ED) of both protocols was calculated using Monte Carlo simulation. Observers then assessed image quality (IQ) at an international radiology congress. The evaluation captured data on demographics, visualisation of the bony anatomy of all body parts with STDCT and ULDCT, and confidence in diagnosis using either protocol. Visual grading analysis (VGA) was used on an absolute scale for IQ rating and comparison. Results Forty-six observers were included in this study, 38-radiographers and eight-radiologists. The percentage ED difference between protocols was 93.5 % (STDCT=0.56mSv vs ULDCT=0.04mSv) and 97.8 % of the observers underestimated the dose reduction when questioned. For the bony anatomy of all body parts, STDCT showed significantly higher IQ than ULDCT (AUCVGA=0.75, asymmetric 95 % CI 0.69–0.8). Conclusion This study demonstrated that 41 % of observers were confident using ULDCT protocol for SPA diagnosis and that ULDCT is a promising technique which may compete with projection radiography. Further work is needed to improve the ULDCT protocol and increase confidence while maintaining an ultra-low dose. ULDCT should be considered as a potential addition to radiographic skeletal survey (SS) in the investigation of SPA. Implications for practice ULDCT provides substantially lower radiation dose with acceptable image quality in a phantom model. While not directly compared with radiographic SS, ULDCT shows potential as a complementary tool for SPA imaging, and further protocol optimisation and evaluation are required before clinical implementation.en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid102148en
dc.identifier.citationMohammed, A., Mahon, E., Moore, N., Sweetman, L., Murphy, M.-J., Beagan, L., Maher, M., England, A., Precht, H. and McEntee, M.F. (2026) 'Ultra-low dose CT for suspected physical abuse', Journal of Medical Imaging and Radiation Sciences, 57(1), 102148 (12pp). https://doi.org/10.1016/j.jmir.2025.102148en
dc.identifier.doi10.1016/j.jmir.2025.102148en
dc.identifier.eissn1876-7982en
dc.identifier.endpage12en
dc.identifier.issn1939-8654en
dc.identifier.issued1en
dc.identifier.journaltitleJournal of Medical Imaging and Radiation Sciencesen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/18348
dc.identifier.volume57en
dc.language.isoenen
dc.publisherElsevieren
dc.rights© 2025, Elsevier Inc., published by on behalf of Canadian Association of Medical Radiation Technologists.en
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectNon-accidental injuryen
dc.subjectPaediatricen
dc.subjectSkeletal surveyen
dc.subjectWhole-body CTen
dc.subjectVisual grading analysisen
dc.subject~Medicine - Journal Articles~en
dc.titleUltra-low dose CT for suspected physical abuseen
dc.typeArticle (peer-reviewed)en
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