It is common practice for many doctors to immediately order up a CT scan for injured children because it easily identifies issues that may not be visible to the eye. However, these scans deliver higher radiation doses than most other types of medical imaging. This has raised concerns about the use of CT on children because their organs are more sensitive to radiation than adult organs and they simply live longer, increasing the chance of developing cancer.

The high increase of computed tomography (CT) examinations of children in U.S. hospital emergency departments between 1995 and 2008 highlights the need for appropriate use and interpretation of these exams. Scans rose from about 330,000 in 1995 to 1.65 million in 2008, a five-fold increase.

CT scanning combines special x-ray equipment with sophisticated computers to produce multiple images or pictures of the inside of the body. These cross-sectional images of the area being studied can then be examined on a computer monitor, printed or transferred to a CD.

CT scans of internal organs, bones, soft tissue and blood vessels provide greater clarity and reveal more details than regular x-ray exams.

Using specialized equipment and expertise to create and interpret CT scans of the body, radiologists can more easily diagnose problems such as cancers, cardiovascular disease, infectious disease, appendicitis, trauma and musculoskeletal disorders.

The research printed in the June edition of Radiology found that CT exams of child head injury, abdominal pain and headache were the most common reasons for the exams. The largest increase was in abdominal CT imaging, which was barely used in 1995 but accounted for 15 to 21 percent of CT exams of children in the last four years of the study.

Dr. David B. Larson, director of quality improvement in the radiology department at Cincinnati Children’s Hospital Medical Center said:

“The performance of CT in children requires special oversight, especially in regards to the selection of size-based CT scan parameters and sedation techniques. It is important to consistently tailor CT technique to the body size of the pediatric patient. (Medical professionals) need to think creatively about how to partner with each other … to ensure that all children are scanned only when it is appropriate and with appropriate techniques.”

The researchers noted that most radiologists who oversee and interpret CT examinations of children are not trained in pediatric radiology.

The CT scanner is typically a large, box like machine with a hole, or short tunnel, in the center. A child would lie on a narrow examination table that slides into and out of this tunnel. Rotating around, the x-ray tube and electronic x-ray detectors are located opposite each other in a ring, called a gantry. The computer workstation that processes the imaging information is located in a separate room, where the technologist operates the scanner and monitors the examination.

For children who cannot hold still for the examination, sedation may be needed. Motion will degrade the quality of the examination the same way that it affects photographs.

Because children are more sensitive to radiation, they should have a CT study only if it is essential for making a diagnosis and should not have repeated CT studies unless absolutely necessary.

Sources: The Journal of Radiology and

Written by Sy Kraft, B.A.