April 6, 2011 -- Emergency CT scans for kids are on the rise -- and so are worries that too many children are getting too much radiation too early in life.
"We found that abdominal CT imaging went from almost never being used in 1995 to being used in 15% to 21% of visits in the last four years of [our] study," Children's Hospital of Cincinnati researcher David B. Larson, MD, MBA, says in a news release.
From 1995 to 2008, Larson and colleagues found a fivefold increase in the percentage of emergency department visits in which children received a CT scan. Nearly 90% of these scans were done in ERs that did not specialize in pediatrics.
"The performance of CT in children requires special oversight," Larson and colleagues note in the June issue of Radiology. "It is possible that non-pediatric-focused radiology departments may be less likely to consistently tailor the CT technique to the body size of the pediatric patient."
That's a concern, as children are far more vulnerable to radiation exposure than are adults:
- Children's organs are more sensitive to radiation than adults' organs.
- Children have a longer life expectancy than adults, giving cancer a longer time to form.
- Radiation settings often may not be set to match children's body size.
- Because CT use is increasing, children may eventually receive a higher lifetime dose of medical radiation.
More Kids Getting CT Scans
CT stands for computed tomography. It's an imaging technique that gives higher image quality than regular X-rays. New CT techniques permit shorter scanning times and result in much better images than ever before -- so CT use is on the rise. It's now a major source of medical radiation in the U.S.
Larson's team analyzed data from a nationally representative survey of emergency department visits from 1995 through 2008. By the end of the study period, 6% of kids who went to the ER got a CT scan.
From 1995 to 2008, CT scans:
- Increased from 0.4% to 3.1% of ER visits by kids younger than age 2.
- Increased from 0.8% to 3.4% of ER visits by kids age 2 to less than 6.
- Increased from 1.5% to 6.5% of ER visits by kids age 6 to less than 13.
- Increased from 2.3% to 10.5% of ER visits by kids age 13 to less than 18.
- 20% to 34% of child ER visits for head injury resulted in a CT scan.
- 20% to 28% of child ER visits for headache resulted in a CT scan.
- 15% to 21% of child ER visits for abdominal pain resulted in a CT scan.
- 18% to 32% of child ER visits for convulsions resulted in a CT scan.
- 25% to 43% of child ER visits for fainting resulted in a CT scan.
- 20% to 40% of child ER visits for flank pain resulted in a CT scan.
CT rates for children with abdominal pain increased more than did CT scans for headache or head injury. That may be increasing U.S. kids' overall radiation exposure, as abdominal CT scans expose kids up to seven times more radiation than do head CT scans.
The findings "underscore the need for special attention to this vulnerable population to ensure that imaging is appropriately ordered, performed, and interpreted," Larson and colleagues conclude.
What can parents do? According to the Radiological Society of North America, parents should talk with the doctor ordering a pediatric CT scan -- or with the radiology physician -- about:
- Whether the scan will result in a clear medical benefit.
- Using the lowest amount of radiation based on the child's size.
- Scanning only the area of the body indicated by the child's symptoms.
- Avoiding multiple scans.
- Using alternative imaging techniques such as ultrasound or MRI.