This article is more than 5 years old. Information may no longer be current.
Children often exposed to imaging procedures using radiation
Dorfman AL. Arch Ped Adolesc Med. 2011;doi:10.1001/archpediatrics.2010.270.
Click Here to Manage Email Alerts
About 40% of children receive a procedure requiring radiation in a given year, and this volume of procedures should prompt clinicians to think more judiciously about the use of this technology, according to a study published online.
“Our findings indicate that more awareness about the frequent use of these tests may be needed among health care providers, hospitals and parents,” Adam L. Dorfman, MD, clinical assistant professor of pediatrics and communicable diseases and radiology at the University of Michigan Medical School, said in a press release. “Imaging tests are a critical component of good medical care, but the high number of tests raises questions about whether we are being judicious in our use of the technology.”
Dorfman and colleagues identified 355,088 children younger than age 18 years in the UnitedHealthCare system between 2005 and 2007 to track how often these imaging procedures are used.
A total of 436,711 imaging procedures using ionizing radiation were performed in 150,000 patients, with 42.5% of the children receiving at least one of these procedures and many undergoing multiple tests. Based on these data, the average child in this study population would be expected to receive approximately seven imaging procedures utilizing radiation by age 18 years, the researchers said.
Plain radiography accounted for 85% of the procedures, and nearly 8% of the children received a CT scan in the 3-year study period, with 3.5% of the children receiving more than one.
“Developing tissues in children are more sensitive to radiation and their longer expected life spans also allows additional time for the emergence of detrimental effects,” study researcher Reza Fazel, MD, a cardiologist at the Emory School of Medicine, said in the release.
The researchers said for any individual child undergoing a single test, the risk is typically low, but they urged that each imaging procedure be guided by the principle of “as low as reasonably achievable” (ALARA), which advocates for minimizing radiation doses while still obtaining sufficient clinical information.
The message here is that imaging studies really do help guide the care of children being treated for infectious diseases. Physicians ordering these studies should ask themselves:
- Is the study really necessary?
- Is there a study that doesn't use radiation that can obtain the same information?
- When a study is done on a child, is it being done at the right institution where "child sized" radiation is used? The differences in radiation dosing from one institution to another can be huge and it's important that the radiology department does everything they can to reduce dose while still obtaining diagnostic studies.
—Jim Donaldson, MD
Children's Memorial Hospital
Chicago, IL
Disclosure: Dr. Donaldson reports no relevant financial disclosures.