A University of Washington study featured in the August issue of JAMA Pediatrics claims that 4 million annual pediatric CT scans of the head, spine, abdomen and pelvis are predicted to cause nearly 5,000 future cancers, according to HealthImaging.com. However, the study goes on to state that the risk can be mitigated by CT dose reduction and appropriate imaging initiatives which have the potential to prevent more than half of the projected radiation-related cancers. Practices like eliminating unnecessary scans and targeting high-dose scans are called out in the study.
I believe that the best way to reduce radiation dose from CT in children is to not do studies which are inappropriate or which have a very low chance of producing impactful diagnostic information. The next best way to reduce dose is to pay close attention to all the tricks of technique: accurate patient centering in the gantry, use of radiation shields, use of 80 or 100 kVp, minimizing Z axis scan length, etc. Then newer technology will greatly further reduce dose – automated tube current modulation, iterative reconstruction – especially fully model-based iterative reconstruction. Together these can reduce radiation dose by 70-80 percent. Scanning in kids above 6-8 mSv should be a thing of the past and sub-1.0 mSv scans should be common.