Best Way to Reduce CT Radiation Dose in Children? No Unnecessary Testing

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.

ACR Releases Radiation Safety and Medical Imaging PSAs

The American College of Radiology, in an effort to address questions and concerns about radiation risk, has created several public service announcements that inform viewers where they can obtain more information regarding radiation in medical imaging. These PSAs have been released for nationwide broadcast.

The adult-focused version of the announcement directs viewers to the Image Wisely site, while the pediatric version directs viewers to the Image Gently site. Each site individually serves as the primary resource for additional information on imaging and radiation safety.

The PSAs can be found here.

Study by Dr. Kanal, UW Researchers Featured in JACR

Recent findings from blog contributor Dr. Kalpana Kanal and her team of University of Washington researchers have been published in the April issue of the Journal of the American College of Radiology!

The purpose of the study was to examine the variation in pediatric trauma head CT imaging protocols in Washington State – including the use (or not) of low radiation dose CT. Based on their findings, the team is now working on a campaign to adopt CT dose reduction protocols throughout the state. For more information on the study, click here.

Great work by Kalpana and her team!