Are pediatric imaging risks overstated?

Computed tomography and its relationship to radiation-induced cancers continues to grab headlines, particularly as it relates to pediatric imaging.

Now a recent study in JAMA Pediatrics suggests that about 4,870 future cancers are induced every year because of the number of children who are exposed to high radiation doses from CT scans.

But are the risks currently associated with computed tomography and pediatric imaging overstated?

As research has shown, starting in the mid 1990s, children were being imaged with CT scans at an alarmingly high rate. The JAMA Pediatrics study found that the number of children who underwent CT scans increased markedly during the decade between 1996 and 2005. But the researchers also determined that those numbers stabilized in 2006 and 2007, and have been declining ever since.

In a study published earlier this year in Radiology, researchers analyzed the records of more than 64,000 trauma patients between the ages of 0 and 54 from 1996 to 2010. They found that for pediatric patients under the age of 15, the use of CT for head injuries peaked in 2004, then gradually declined through 2010, while pelvic and abdominal CT exams for patients under 15 peaked in 2005, and then decreased through 2010.

So, is the glass half empty or half full? We continue to be concerned about the amount of medical radiation to which we expose our children, yet it appears we also have taken steps to reverse what had been a dangerous trend.

It seems that medical imaging professionals and manufacturers have gotten the message. Modern CT scanners now use radiation doses that are substantially lower than those that were being used when CT scanning was at its peak. And providers are aggressively looking for ways to improve imaging quality while lowering dose.

For example, Texas Children's Hospital recently became the first children's hospital in the nation to begin using a PET/MRI scanner, a cutting edge technology capable of diagnosing cancers, heart diseases and neurologic conditions while exposing young patients to a much lower level or radiation than they would receive from PET/CT.

In addition, organizations like the American College of Radiology, the Radiological Society of North America, the American Society of Radiologic Technologists and the Society for Pediatric Radiology all have been actively engaged in efforts to reduce dose and ensure appropriate imaging. The Image Gently campaign--which focuses on pediatric patients--is just one of those efforts.

Clearly, efforts must continue to reduce dose, eliminate unnecessary imaging and make sure the imaging that does take place is appropriate. But we can also take some comfort in the fact that current efforts seem to be bearing fruit. - Mike  @FierceHealthIT

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