Use of CT Scans Skyrockets Among Kids, Experts Worry About Radiation Exposure
Researchers collected survey data over a 14-year period, spanning from 1995 to 2008, and found that ER visits that included a CT exam jumped from 330,000 to 1.65 million. That’s a fivefold increase in scans.
Eight-nine percent of the visits were to non-pediatric hospitals, and the radiologists who oversaw and interpreted the scans were likely not trained in pediatric radiology, according to the study’s lead author Dr. David Larson, director of quality improvement, Department of Radiology at Cincinnati Children’s Hospital Medical Center.
“We need to think creatively about how to partner with each other, with ordering clinicians and with CT manufacturers to ensure that all children are scanned only when it is appropriate and with appropriate techniques,” Larson said.
The injuries that most often result in a CT exam include head injuries, abdominal pain and headaches. Scans for abdominal pain showed the biggest increase, thanks to technology improvements – but researchers say this may not an entirely positive finding.
Though abdominal CT imaging is widely available, thorough and fast, the radiation dosage is up to seven times that of a head CT.
Experts say the increase in CT scans for children overall is likely being driven by parents who are pushing for them more, and doctors who are willing to perform them.
“Doctors are afraid of missing things, afraid of missing a diagnosis,” said Dr. James Chamberlain, division chief, Emergency Medicine & Trauma Services at Children’s National Medical Center in Washington, D.C. “They are afraid of malpractice and parents are more likely to advocate for their children than they were 10-15 years ago.”
Chamberlain emphasized, however, that because of the risks associated with excess radiation exposure, parents should make a point to ask doctors if their child really needs a CT scan.
“This study is alarming and should make all of us very concerned about radiation and children’s brains and abdomens,” he said. “Hospitals should be examining their practices, they should be benchmarking individual doctors against each other and against national standards and they should be assuring that appropriate doses of radiation are used for children.”
According to Chamberlain, criteria have already been developed on who actually needs a CT scan for a head injury. Those patients include people who have been unconscious, have a deformed head, are vomiting, suffered a severe injury such as being in a car that has rolled over. The setting of criteria for abdominal scans is under way.
Meanwhile, the Alliance for Radiation Safety in Pediatric Imaging is heading a national campaign called “Image Gently,” the goal of which is to increase awareness about lowering radiation doses in children, and harness the expertise of pediatric hospitals to teach non-pediatric hospitals how to use the appropriate dosages of radiation.