Think Twice Before Ordering That CT

Abstract

Radiology| October 01 2002 Think Twice Before Ordering That CT AAP Grand Rounds (2002) 8 (4): 41–42. https://doi.org/10.1542/gr.8-4-41 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Think Twice Before Ordering That CT. AAP Grand Rounds October 2002; 8 (4): 41–42. https://doi.org/10.1542/gr.8-4-41 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: cancer, computed tomography, diagnostic radiologic examination, radiation exposure, radiologists, radiotherapy dosage, cancer risk, spiral computed tomography Source: Society of Pediatric Radiology. The ALARA (As Low As Reasonably Achievable) concept in pediatric CT intelligent dose reduction. Multidisciplinary conference organized by the Society of Pediatric Radiology. August 18–19, 2001. Pediatr Radiol. 2002;32:217–313. On January 22, 2001, USA Today published a front page article entitled “Radiation from CT scans in children linked to cancer.”1 This controversial and somewhat distorted report sensationalized the results of 3 articles and an editorial published in the February 2001 issue of the American Journal of Roentgenology. Roentgenology 2–,4 The 3 articles included an estimation of cancer risk from pediatric computed tomography (CT), a critical evaluation of why the helical CT technical settings used throughout the general radiology community were not adjusted for children, and strategies on how to minimize radiation dose during pediatric body CT using a single detector helical scanner. A flood of public outcry hit the medical community, focused primarily on pediatricians. Concerned, fearful, and angry parents worried about their child’s CT examination, and in some cases blamed CT radiation for their child’s cancer. In response, the Society for Pediatric Radiology organized a conference in August 2001 to address the scientific aspects of this controversy and expand on the “ALARA” (As Low As Reasonably Achievable) concept that is generally applied by radiologists to any medically necessary radiation exposure. The following summarizes excerpts from those presentations. The use of pediatric CT exams has risen from 4% of all CT scans performed in 1989 to around 10% today. An estimated 2.7 million children receive CT exams every year in the United States. CT scans account for only 10% of x-ray exams but contribute a disproportionate 67% of the overall collective radiation dose. Multiple exams are often performed in the same patient with approximately 30% of patients having at least 3 CT exams; 11% have more. Children are more sensitive to radiation than adults by a factor of 10; girls are at more risk than boys by a factor of 2; and exposure at a younger age (especially below 15 years) carries a significantly higher risk of cancer. Since radiation-induced cancers appear at about the same age as spontaneous cancers of a similar type, it takes many years to test the current “estimation” of increased cancer risk in patients exposed to CT, a technology which has not been around long enough to permit such study in children. The reported risks are “estimates” calculated from a multitude of factors that are dependent upon radiation dose per organ as a function of gender, age, weight, type of CT, and dose calculation based on electronic models and data from studies of atomic bomb survivors. Nonetheless, it is certain that radiation from CT scans is a contributing factor to the rate of cancer in the general public, although to what extent is difficult to accurately determine. The ALARA conference organizers call for a more judicious selection of patients for CT examination and note the need for further investigation of appropriate parameters... You do not currently have access to this content.