What can I do to increase safety in the use of CT? - Radiologists
Technologists     Medical Physicists     Parents

• Click here for a comprehensive Background and Guideline document - authors Donald P. Frush, MD, Michael Callahan, MD, Marilyn Goske, MD, Sue Kaste, DO and Marta Hernanz-Schulman, MD
• Click here for the PowerPoint Presentation, "Medical Radiation in Children," made available by the Society for Pediatric Radiology. You may use this presentation to educate your colleagues locally and you may develop a shorter presentation by selecting from the slides. We do ask that you not alter the slides and that you attribute the SPR in any presentation. 
• NEW! Image Gently Web-based Practice Quality Improvement Program

“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
Chair, Board of Directors, The Society for Pediatric Radiology