Exposure to Ionizing Radiation from Initial Brain Computed Tomography for Injuries in the South-West Region of Cameroon

Abstract

The increasing use of computed tomography (CT) in injury management is a growing concern as ionizing radiation (IR) is associated with cancer-related risks especially in young persons, who are most affected by injuries. This study aimed to assess ionizing radiation exposure from head CT in patients with injuries and to propose CT dose age-specific diagnostic reference levels (DRLs). Data was extracted from two prospectively collected CT registries over a period of 5 years at two community-based university-affiliated hospitals from 2019 to 2024. The linear relationship between CT dose (dose-length product; DLP) and age was assessed using Pearson’s correlation whilst linear regression was used to determine the strength of the relationship. The 75th percentiles and 95% confidence intervals (CIs) of the DLP were determined. Eligible initial head CT scans for patients with injuries were 1,155. There were 685 (59.31%) males (sex ratio of 1.5:1) and overall median age of 33 years (interquartile range: 21 to 46). Road traffic injuries were the source of injury in 1090 individuals (94.37%; 95% CI: 92.88 - 95.63%), followed by falls (50 cases; 4.33%; 95% CI: 3.23 - 5.67%) and assaults (10 cases; 0.87%; 95% CI: 0.42 – 1.59). The median DLP was 1,062 mGy.cm (range: 264 to 1,954 mGy.cm). There was a positive linear relationship between the DLP and the age of the patients (Pearson’s rho = 0.38, p<0.001). DRLs were comparable to international values. Measures to curb the rising incidence of injuries and the continuous implementation of CT optimization techniques will reduce IR exposure.