Abstract
Background
Concern has been raised about the potential risks related to radiation exposure from CT scans, particularly among children. However, to date, there are few data available describing the magnitude of pediatric CT utilization.
Objective
The aim of the study was to explore patterns of CT use in pediatric patients, with respect to time, use of multiple scans, body regions imaged, and medical diagnoses.
Materials and methods
Records of 22,223 scans performed on 18,075 people aged ≤18 years over the period 1999–2003, including diagnoses recorded within 21 days after the examination, were obtained from a large Israeli Health Maintenance Organization (1,600,000 members).
Results
The highest annual CT examination rate (per 1,000) was recorded in 2001 (10.1) compared to 7.0 and 6.3 in 1999 and 2003, respectively. The lowest rate (three scans per 1,000) was found for 3-year-old children, with increasing rates with age. The head was the most frequently scanned region, both in young children (78%) and adolescents (39%). Symptoms of ill-defined conditions and injuries were documented in 22% and 10% of all scans, respectively.
Conclusions
Although the results suggest that children comprise only 3% of all patients undergoing CT, this important modality must be carefully used because of their increased radiosensitivity, higher effective radiation doses, and longer life expectancy.
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References
Shrimpton PC, Edyvean S (1998) CT scanner dosimetry. Br J Radiol 71:1–3
Hart D, Wall BF (2004) UK population dose from medical X-ray examinations. Eur J Radiol 50:285–291
Brenner DJ (2002) Estimating cancer risks from pediatric CT: going from the qualitative to the quantitative discussion. Pediatr Radiol 32:228–231
Brenner D, Elliston C, Hall E, et al (2001) Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR 176:289–296
Linton OW, Mettler FA Jr; National Council on Radiation Protection and Measurements (2003) National conference on dose reduction in CT, with an emphasis on pediatric patients. AJR 181:321–329
Ron E (2003) Cancer risks from medical radiation. Health Phys 85:47–59
Brasch RC, Boyd DP, Gooding CA (1978) Computed tomographic scanning in children: comparison of radiation dose and resolving power of commercial CT scanners. AJR 131:95–101
UNSCEAR (2000) Sources and effects of ionising radiation. Annex D: medical radiation exposures. United Nations Scientific Committee on the Effects of Atomic Radiation, New York
World Health Organisation (1975) International classification of diseases (ICD), 9th revision. WHO, Geneva
Mettler F, Wiest P, Locken J, et al (2000) CT scanning: patterns of use and dose. J Radiol Prot 20:353–359
Sacchetti A, Carraccio C, Giardino A, et al (2005) Sedation for pediatric CT scanning: is radiology becoming a drug-free zone? Pediatr Emerg Care 21:295–297
Frush D, Donnelly L, Rosen N (2003) Computed tomography and radiation risks: what pediatric health care providers should know. Pediatrics 112:951–957
Sikron F, Giveon A, Aharonson-Daniel L, et al (2004) My home is my castle! Or is it? Hospitalizations following home injury in Israel, 1997–2001. Isr Med Assoc J 6:332–335
Luxenburg O, Vaknin S, Pollack G, et al (2003) Utilization patterns of CT and MRI in Israel. Harefuah 142:810–814
Paterson A, Frush DP, Donnelly LF (2001) Helical CT of the body: are settings adjusted for pediatric patients? AJR 176:297–301
Donnelly LF, Emery KH, Brody AS, et al (2001) Minimizing radiation dose for pediatric body applications of single-detector helical CT: strategies at a large children's hospital. AJR 176:303–306
Kaste SC, Young CW, Holmes TP, et al (1997) Effect of helical CT on the frequency of sedation in pediatric patients. AJR 168:1001–1003
Pappas JN, Donnelly LF, Frush DP (2000) Reduced frequency of sedation of young children with multisection helical CT. Radiology 215:897–899
Huda W (2002) Dose and image quality in CT. Pediatr Radiol 32:709–713
Shrimpton PC, Hillier MC, Lewis MA, et al (2005) Doses from computed tomography (CT) examinations in the UK – 2003 review. Health Protection Agency, Didcot, UK. Available at http://www.hpa.org.uk/radiation/publications/w_series_reports/2005/nrpb_w67.htm. Cited 6 Dec 2005
Huda W, Atherton JV, Ware DE, et al (1997) An approach for the estimation of effective radiation dose at CT in pediatric patients. Radiology 203:417–422
Hollingsworth C, Frush DP, Cross M, et al (2003) Helical CT of the body: a survey of techniques used for pediatric patients. AJR 180:401–406
Frush DP (2002) Pediatric CT: practical approach to diminish the radiation dose. Pediatr Radiol 32:714–717
Lee CI, Haims AH, Monico EP, et al (2004) Diagnostic CT scans: assessment of patient, physician, and radiologist awareness of radiation dose and possible risks. Radiology 231:393–398
National Cancer Institute (2002) Radiation and pediatric computed tomography: a guide for health care providers. National Cancer Institute, Bethesda, MD
National Academies of Sciences (2005) Health risks from exposure to low levels of ionizing radiation: BEIR VII Phase 2. http://www.nap.edu/books/030909156X/html
Acknowledgement
This research was supported in part by the Intramural Research Program of the Radiation Epidemiology Branch, National Cancer Institute, NIH.
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Chodick, G., Ronckers, C., Ron, E. et al. The utilization of pediatric computed tomography in a large Israeli Health Maintenance Organization. Pediatr Radiol 36, 485–490 (2006). https://doi.org/10.1007/s00247-005-0091-0
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DOI: https://doi.org/10.1007/s00247-005-0091-0