ACR data shows pediatric body CT exams on the rise

Pediatric body CT exams are on the rise in the United States, especially among older children, according to a new analysis of data from the American College of Radiology (ACR) CT Dose Index Registry (DIR). The authors used the data to break down various demographics of common pediatric body CT exams, publishing their findings in the American Journal of Roentgenology.

Overall, the authors studied more than 411,000 single-phase pediatric CT exams of the abdomen/pelvis and chest/head that had been submitted to the ACR DIR from July 2011 to June 2016. They found the number of pediatric CT scans submitted to the ACR DIR “increased each year and nearly every quarter.” During the last two quarters of the study, which were the first two quarters of 2016, more than 71,000 such exams were submitted.

Looking closer at the most common single-phase pediatric CT exams—head CT, abdominopelvic CT and chest CT—the data revealed that boys were imaged more frequently than girls, with two significant exceptions.

“In the two largest age groups of abdominopelvic CT (11–14 and 15–18 years), girls underwent scanning more often,” wrote lead author Benjamin Wildman-Tobriner, MD, department of radiology at Duke University in Durham, North Carolina, and colleagues. “The reasons behind this trend are not clear, but one contributing factor may be the many genitourinary conditions unique to female adolescents (such as adnexal disorders).”

Wildman-Tobriner and colleagues added that 32 percent of chest CT exams were not actually single-phase studies.

“Some examinations may have been labeled incorrectly, and others may not have fit into the DIR classification options,” the authors wrote. “These studies may have been started as single phase and then been converted to multiphase without relabeling. Some studies might have required additional anatomic coverage.”

The ACR DIR also includes dose estimate information, establishing benchmarks for various dose-monitoring programs throughout the country. This is just one way contributing to the directory can be beneficial for a provider, according to the authors. “Periodic reports sent by the DIR to contributing sites include site-specific information, and reports assessing geographic information and practice types can be used to provide additional value for the broader medical community,” they wrote.

The DIR does have limitations, however. It requires an annual subscription fee, for example, and some older data “are not as accurate as more recent data.” But even considering these limitations, Wildman-Tobriner et al. said the DIR was easy to access, its data was helpful for research purposes and directory staff was “helpful and responsive” when researchers had questions.