A recently released report suggests some doctors are relying too heavily on certain imaging tests–which may contribute to the rising costs of medical care as well as exposing patients to unnecessary amounts of radiation. The report’s findings are of special concern for younger patients, who are more susceptible to risks associated with radiation than adults.
In response, the staff of Children’s Hospital Boston’s Department of Radiology and Nuclear Medicine and Molecular Imaging is working to keep the radiation dose given to patients as low as possible while providing all the information doctors need to treat patients. Imagers at Children’s who use CT (computed tomography) scans to produce high-quality images of inside their patient’s bodies have gone to great lengths to ensure their procedures are as safe as possible.
“No concrete published data has linked radiation damage to the radiation dose level of a CT scan, but the small potential risk suggests that all reasonable efforts should be made to reduce these radiation dose levels when imaging children,” says Keith Strauss, M.Sc, director, Radiology Physics and Engineering at Children’s Hospital Boston.
The radiation dose level from a CT scan is larger than the radiation dose from a chest x-ray, which may be of concern when applied to younger patients as the rapidly dividing cells of children are more susceptible to damage by x-ray radiation than the slower dividing cells of adults. As a result, Strauss says CT imagers should be using doses that are “As Low as Reasonably Achievable,” or ALARA doses, when imaging kids.
Along with Michael Callahan, MD, Children’s director of CT imaging, Strauss is a member of the steering committee of the Alliance for Radiation Protection in Pediatric Imaging, an international organization dedicated to educating medical professionals and parents about the potential risks associated with CT scans in children. Together they’re leading an effort within Children’s Radiology Department to reduce the amount of radiation used for CT scans, and to reduce the overall number of CT scans given to kids. For instance, in some clinical situations, ultrasound or MRI examinations—both of which do not use ionizing radiation—can be as accurate as CT scans, but the appropriateness of their use depends on each patient’s needs and the problem being examined.
When a CT scan is the best option for obtaining a clear diagnosis, radiologists at Children’s use the smallest radiation dose that produces images of diagnostic quality. In order to obtain these images in the safest environment for children, Strauss says Children’s adjusts the operating parameters of its CT machines to pediatric settings, which reduces the amount of ionizing radiation administered.
Though confident in Children’s efforts to lower potential risk of radiation damage to children, Strauss and Callahan continue to work through the Alliance to encourage other health care providers to properly adjust the radiation doses in CT scans of their pediatric patients. “The ultimate goal is to ensure that all pediatric patients receive CT examinations that are appropriately tailored to the size of the child,” Strauss says.
To help parents understand risk and spread factual information about pediatric imaging, Strauss encourages parents to talk to their pediatrician if it’s recommended their child has certain scans done. “Parents should ask questions of their primary care physicians if they have concerns,” he says. “They should feel empowered to discuss possible alternative tests that do not involve ionizing radiation if they feel it’s in their child’s best interests.”