Necessary Pediatric CT Scans Save Lives!

The following article was written by John MacKenzie, M.D., Chief, Pediatric Radiology, Assistant Professor in Residence at UCSF.

We need to carefully examine the results of a study published recently in the Lancet.  The study suggests a correlation between increased cancer risk and computed tomography (CT) scans for children under the age of 10 years.  The study has brought to light a number of important considerations for patients and parents.

In general, medical imaging examinations are effective and life saving tests proven to increase life expectancy and decrease mortality rates (included patients with cancer).  Medical imaging is also a safer and less expensive alternative to invasive procedures.  Modern CT scanners have dose-reduction capabilities that markedly lower the dose while providing acceptable image quality. Also, the awareness among practitioners about the need to justify and optimize CT doses is very high.  The study in the Lancet looked at children who were scanned with CT technology from 1985 to 2002.  Dose reduction strategies and new CT technologies since then have markedly decreased the dose that patents receive.

The widespread use of CT has resulted in higher levels of radiation exposure for the general population—including children.  However, children who receive these scans do so for an immediate and significant health condition. These medical imaging exams are most often used on children after traumatic head, neck, or spine injury, neurological injury or disorder, or complex and life threatening clinical issues requiring quick and accurate evaluations. Thus, if a CT scan is warranted and deemed necessary, the immediate benefits far outweigh the potential for a very small long-term cancer risk.

At UCSF we are advocates for the rational and appropriate use of medical imaging.  Parents should also join us in this advocacy role.  Parents may help by maintaining a record of their child’s radiation history and ask their health care provider before any imaging exam. It is important to get the full set of facts, including alternative tests and benefits of the information provided by the CT scan.

At UCSF no imaging exam is performed without clear medical benefit.  When the decision is made to obtain a CT scan, the immediate benefit of the information provided by the test far outweighs the very small potential risk of developing cancer.

Radiation dose reduction is also a top priority at UCSF.  We tailor each examination to the patient’s body size and use sophisticated techniques that minimize dose reduction while maintaining image quality to help provide a diagnosis.   We are committed to the Image Wisely and Image Gently campaigns, in addition to vigilant and ongoing efforts to ensure appropriate and safe imaging practices.