Children and CT Scans

In June 2013, an article was published in JAMA Pediatrics that discussed the use of CT scans in children, and the risk of developing cancer in the future. A CT scan can be a very useful tool for a physician to use to either make, or confirm, a diagnosis if your child is having a medical problem. It is important for families to understand that a CT scan uses radiation, and we know that exposure to radiation is linked to cancer.

The Study: The link between CT scans and cancer

The information from the JAMA Pediatrics study describes the overall increase of use in CT scans in children over the past 20 years. The number of pediatric CT scans increased until about 2006, and then began to decline. The amount of radiation in a CT scan can be 100 to 500 times greater than a plain x-ray. Children are very sensitive to exposure to radiation that can cause future cancer because of their young age, and because they have many more years of growth and development ahead of them.

In this study, the researchers estimate that 4 million CT scans performed on children in one year in the United States are projected to cause about 4,800 cancers in the future. The risk of developing cancer from the radiation exposure of a CT scan depends on several factors:

• The younger a child is, the higher the risk of developing a cancer from exposure to radiation.
• The risk increases depending on what type of CT scan was performed. A CT scan of the abdomen and pelvis had the highest risk of solid cancer development, as compared to other types of CT scans (examples: chest, brain).
• The risk of leukemia was highest from CT scans of the head in children younger than 5 years old.

This information is scary for everyone – patients, parents, and physicians. And even though we realize that these numbers and predictions are frightening, it is also important to remember that children’s lives are also saved by diagnoses made by CT scans. We need to work together to use CT scans when appropriate, and consider other alternatives to a CT scan whenever possible.

What can a parent do to help reduce a child’s exposure to radiation?

If your child is receiving medical care, as a parent or caregiver, you can help advocate for them by asking your child’s treating physician about the risks and benefits of a particular imaging test. You can ask them if the test is truly necessary at the present time, or if watchful waiting or observation is a reasonable option for your child.

You can also ask your physician if an alternative test would be possible, instead of a CT scan. For example, if your child has abdominal pain, then a healthcare provider may want to evaluate for appendicitis. Sometimes a CT scan is used, but a better option in a child to assess appendicitis is an abdominal ultrasound. Ultrasounds can be helpful in detecting appendicitis, and they expose your child to zero radiation.

If your child is injured or has developed a medical condition, try to seek medical attention at a facility that takes care of many pediatric patients. At a children’s hospital, a pediatric radiologist is part of the medical team that oversees and interprets the imaging studies performed on children. The pediatric radiologist can help ensure that your child receives the minimal necessary dose of radiation required for an imaging study, thus lowering your child’s exposure to unnecessary ionizing radiation.

As a parent, make it a habit to keep track of all imaging studies that your child has received. The Image Gently campaign encourages parents to become advocates for their children, and to become a part of the medical-decision making process when your child is receiving medical care that may require imaging studies. The goal of this campaign is to change practice by increasing awareness of the opportunities to promote radiation protection in the imaging of children. On this website, you can learn more about how we can protect our children from unnecessary radiation exposure, and download the My Child’s Medical Imaging Record to help you establish a record of your child’s imaging studies.

What are we doing at Arnold Palmer Hospital for Children to help protect your child from unnecessary radiation?

As a pediatrician, I encourage parents and families to become part of the decision making in the medical care of their child. This includes having an open discussion about the risks and benefits of each test or imaging that may expose a child to radiation, and other alternative options that may also include close observation.

At Arnold Palmer Hospital, we have a team of pediatric radiologists that are dedicated to making sure that your child receives the lowest necessary dose of radiation for an imaging test or procedure. We work closely with our pediatric radiologists to help determine the best imaging test for a child. We frequently use MRI and ultrasounds in children, and these studies use no ionizing radiation. Our pediatric radiologists use radiation-sensitive techniques, and follow the Society for Pediatric Radiology’s guidelines to ensure that your child is exposed to the minimal amount of ionizing radiation needed for an imaging study.

As a parent, you are the strongest advocate for your child. We encourage you to be a part of the team that makes decisions for your child’s healthcare and medical treatment. Keep track of all of the imaging and tests that your child has had so that healthcare providers may be aware of the amount of radiation that your child has been exposed to. Understand that there is definitely a role for CT scans in children and it can save lives, but also know that there may be other alternatives to CT scans. And as always, remember that your pediatrician or family physician will be able to help provide you with information, answer your questions, and guide you in providing the best healthcare for your child.