Children exposed to more radiation at nonpediatric hospitals than pediatric facilities

Children receiving CT scans at nonpediatric hospitals (NPHs) are exposed to twice as much radiation as children being imaged at pediatric hospitals using an optimal scanning protocol (OSP), according to a new study published by the Journal of the American College of Radiology.

Researchers compared the effective radiation dose (ERD) of injured children younger than 18 years old who received a CT scan in 2010 and 2013 within a single state trauma system. The years were chosen because the system’s image repository was created in July 2011.

Overall, the ERD received at NPHs was 3.8 mSv and the ERD for patients at pediatric hospitals was 1.6 mSv. The authors attributed much of this difference to the effectiveness of OSPs, which are becoming more and more common throughout the United States as radiology continues its shift from volume to value.

“Clinicians at NPHs have the potential to substantially reduce the medical radiation injured children receive by adopting OSPs similar to that used at pediatric trauma centers,” wrote lead author Rosemary Nabaweesi, DrPH, MBChB, MPH, University of Arkansas for Medical Sciences in Little Rock, and colleagues. “Careful analysis of patterns across a state trauma system affords an ideal opportunity to propose standardized scanning protocols based on real-world feedback delivered directly to hospitals and radiology staff.”

The data collected by Nabaweesi et al. included more than 480 children. The median patient age was 7.2 years old, and the median length of stay in the emergency department was 3 hours.

The authors said their system works to follow the “As Low as Reasonably Achievable” principle, supported by both the American College of Radiology and the American Association of Physicists for Medicine, by following OSPs and using more modern CT technology.

The team added that the study did have limitations, including the wide variety of CT scanners used and the fact that “the majority of CT scans were performed on the head.