Research highlights rampant 'over-scanning' during pediatric CT exams
Concerning new data suggest the majority of pediatric patients are “over-scanned” during head CT exams.
Published in the European Journal of Radiology, the study suggests that up to 77% of pediatric head CTs expose children to more radiation than necessary. Experts involved in the study caution this increases children’s risk of developing radiation-induced malignancies down the road.
“The increasing reliance on computed tomography in pediatric clinical practice has raised major concerns regarding radiation-induced cancer risks,” Farshid Mahmoudi, with the School of Allied Medical Sciences in Iran, and colleagues noted. “Although the brain is relatively less radiosensitive than many other organs, children are particularly more susceptible to radiation-related harm due to their smaller body size, greater tissue sensitivity, and longer post-exposure life expectancy.”
For their analysis, researchers examined the cases of more than 100 children who underwent head CTs at three different hospitals. The group measured organ doses using size-specific dose estimates and Monte Carlo simulations and calculated lifetime attributable risks based on age and sex. Scanning direction—craniocaudal versus caudocranial—also were analyzed to determine whether one resulted in greater tissue exposure.
The highest doses measured were in the brain, eye lenses, oral mucosa, salivary glands, red bone marrow and thyroid. The team estimated that lifetime attributable risk was highest for thyroid cancer, leukemia, lung and breast cancer, with age and risk having an inverse relationship and girls being more susceptible.
The team observed over-scanning in nearly 78% of the exams. This finding was exclusive to the caudal direction and significantly increased exposure to radiation in nearby organs and tissues. The group estimated this finding increases the risk of thyroid cancer in females specifically by over 250%.
This could be addressed, in part, by educating technologists on the risk of extending scanning parameters in children, which is common practice to avoid missing important pathology, the authors noted.
“This emphasizes the importance of targeted training for technologists in accurately defining caudal anatomical landmarks, strict adherence to pediatric scanning protocols, and considering automated range-selection tools,” the experts advised. “Reducing unnecessary caudal overs-canning is crucial to minimize radiation dose and enhance patient safety in pediatric brain CT examinations.”
Read more about the findings here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.