CT Scans - What can I do as a Radiologist?

"Child-size” the radiation delivered to your patients

Radiologists play a key role as healthcare providers for children. Radiology  and CT scanning is  critical in diagnosing illness in children and impacting their treatment and improving patient outcomes. By logging onto this website, you have already shown your commitment to improve radiation protection for kids. It is the responsibility of radiologists and all members of the healthcare team to ensure that every imaging study in pediatric patients is thoughtful, appropriate and indicated for  each and every child. As a radiologist in a busy practice with many adult patients, it may be difficult to “kid-size” the protocols used every day. This website provides simple educational resources to inform radiology practices what can be done now to improve radiation protection for children.

Soon medical imaging (with CT scans as the largest contributor) will approach or potentially exceed background radiation as the single largest source of radiation for humans (NCRP, April 2007) . Research is clear… children are more sensitive to radiation and have a lifetime to manifest those changes. Studies from the atomic bomb indicate that radiation at low levels can cause random injury at the DNA level and genetic changes that impact children’s future health. 

Here are 5 simple steps to improve patient care in your everyday practice: 

  1. Increase awareness for the need to decrease radiation dose to children during CT scanning. Protocol development recommendations are offered under What can I do? or directly here.
  2. Be committed to make a change in your daily practice by working as a team with your technologists, physicist, referring doctors and parents to decrease the radiation dose! Sign the pledge! Click on the link on the home page to join the image gently campaign today.
  3. Contact your physicist to review your adult CT protocols and then use the simple CT protocols on this website to “down-size” the protocols for kids. More is not better….adult size KV and mAs are not necessary for small bodies.
  4. Single phase scans are usually adequate. Pre- and post contrast, and delayed CT scans rarely add additional information in children yet can double or triple the dose! Consider removing multi-phase scans from your daily protocols.
  5. Scan only the indicated area. If a patient has a possible dermoid on ultrasound, there is rarely need to scan the entire abdomen and pelvis. “Child-size” the scan and only scan the area required to obtain the necessary information.

    Marilyn J. Goske, MD, Alliance Chair
    Pediatric Radiologist
    Past President, The Society for Pediatric Radiology

CT Resources

CT Resources

Image Gently - Digital Radiography Educational Materials

BACK TO BASICS - What does that mean?

To learn more, print the BASICS acronym by clicking here for a poster to use in your department as an image analysis tool.

PARENT BROCHURE

The Image Gently Digital Radiography writer's group has created the parent brochure entitled X-rays for Children:  What Parents Should Know About Radiation Protection in Medical Imaging".  This full color brochure was designed to be printed locally and distributed to parents and patients.  Click here to download this valuable resource now.

EDUCATIONAL RESOURCES FOR MEDICAL PROFESSIONALS

POWER POINT PRESENTATIONS

The Image Gently Digital Radiography work group has created several Power Point presentations to help you in your work with pediatric patients.  

PUBLISHED PAPERS

  • Best Practices in Digital Radiography - first author Tracy L. Herrmann, M.Ed., R.T.(R) is a member of the Image Gently DR Committee.  This white paper appears in the September 2012 Issue of Radiologic Technology, Volume 84, Number 1.  Shared here with permission from ASRT.
  • Image Gently: Using Exposure Indicators To Improve Pediatric Digital Radiography - an ASRT Special Report written by Quentin T Moore, MPH, R.T.(R)(T)(QM) and the Image Gently DR Writer's group.  This article is featured in the September 2012 Issue of Radiologic Technology, Volume 84, Number 1.  Shared here with permission from ASRT.    


The Image Gently Digital Radiography writer's group has created the parent brochure entitled X-rays for Children:  What Parents Should Know About Radiation Protection in Medical Imaging".  This full color brochure was designed to be printed locally and distributed to parents and patients.  Click here to download this valuable resource now.

 

IR - What can I do as a Radiologist?

“Child- size” the radiation delivered to your patients. Pediatric and interventional radiologists play a key role as healthcare providers for children. Interventional radiology is a critical medical service which saves lives and improves patient outcomes. By logging onto this website, you have already shown your commitment to improve radiation protection for kids. It is the responsibility of radiology providers and all members of the healthcare team to ensure that every interventional radiology procedure in pediatric patients is thoughtful, indicated and appropriately performed for each and every child. As a practitioner in a busy practice with many adult patients, it may be difficult to “kid-size” the protocols used every day. This website provides a simple review of “child-size” IR practices which can be used now to improve radiation protection for children.
 
Soon medical imaging (with IR as the third largest contributor, after CT and nuclear medicine) will approach or potentially exceed background radiation as the single largest source of radiation for humans (NCRP, March 2009). Children are more sensitive to radiation and have a lifetime to manifest those changes. Studies from the atomic bomb indicate that radiation at low levels can cause random injury at the DNA level and genetic changes that impact children’s future health.

Here are 5 simple steps to improve patient care in your everyday practice:

  1. Increase awareness within your medical team and within the institution for the need to decrease radiation dose to children during IR procedures. Procedure recommendations are offered here.
  2. Be committed to make a change in your daily practice by working with your technologists, physicist, referring doctors and parents to decrease the radiation dose! Sign the pledge! Click on the link on the home page to join the image gently campaign today.
  3. Contact your physicist and manufacturer to review your adult angiography and CT protocols and to “down-size” the protocols for kids. More is not better… adult techniques are not necessary for small bodies.
  4. During the procedure, “step lightly” on the fluoroscopy pedal, using the least amount of radiation needed to safely and effectively perform the procedure. Remember to take other common sense steps to reduce dose, such as planning runs in advance, using pulse fluoroscopy, using US or MRI for guidance when possible, and minimizing use of magnification.
  5. Remember that reducing patient dose reduces dose to personnel in the room: as you work to reduce dose to children, you will also help your healthcare team.

 

Go with the Guidelines

 

Minimizing Radiation Risk

Optimizing Pediatric Imaging Protocols

Toward Optimal Pediatric Nuclear Medicine Imaging: A discussion for imaging professionals and medical physicists - It is inherently challenging to optimize protocols for pediatric nuclear medicine. In general, optimal protocols provide the maximum image quality (benefit) at a minimum of risk. In nuclear medicine, images are required to perform a range of clinical tasks from detection of disease to monitoring a therapeutic response. It is difficult to quantify, and therefore maximize, image quality for this range of tasks.  Prepared by Adam Alessio, PhD, DABSNM.

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