Medical Imaging: Small Doses Keep Kids Safe

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Kid-size Radiation Doses

In medical radiation, one size does not fit all.

Children who take medicines are given “kid-sized” doses because of their size. They eat from the kid’s menu and have their own special clothes that fit them. But when a doctor orders a CT scan (computed tomography), ultrasound or MRI for a child, not all hospitals reduce the amount of radiation to fit the child’s size.

Nathan Ormsby of Beavercreek has undergone more imaging tests than many children his age. The 5-year-old is a regular in the medical imaging department at The Children’s Medical Center of Dayton since being diagnosed with stage IV neuroblastoma, cancer of the sympathetic nervous system, in August 2006.

“Nathan has had CT scans, x-rays, MRI, bone scans, nuclear medicine tests. I think he’s had every imaging procedure you have here,” Nathan’s mother, Rachel says. For that reason, she is grateful that Dayton Children’s takes care to minimize radiation doses.

The pediatric radiologists at Dayton Children’s individualize each CT examination to account for a child’s weight and size, ensuring that the child receives the minimum radiation needed to complete the procedure.

“Children are typically smaller than adults and require less radiation to penetrate the body,” says Elizabeth Ey, medical director of medical imaging at Dayton Children’s. 

“The actively growing tissues in children are more sensitive to radiation. A child’s life expectancy is longer compared to an older adult meaning the effects of radiation exposure last longer in a child. Doctors who choose to image a child should expose him or her to kid-sized doses. More is not always better.” 

In 2006, about four million CT scans were performed in children. This is triple the number of scans in 2001.

“CT scans help us save children’s lives, but should only be performed when necessary,” Ey says.

“Alternative imaging to CT scanning, like ultrasound and magnetic resonance (MRI) should be considered whenever possible.”

Ey says the medical imaging department at Dayton Children’s is proud of its history of doing the right thing for their patients. 

“Radiation safety has always been a priority for us. We continue to improve our ways to diagnose childhood illness in a safe and caring environment.”

Medical Imaging Frequently Asked Questions

If my doctor orders a CT scan, should I let my child have it?
Like any medical test, the beneficial information gained from the test should outweigh the risk of having the test performed. CT is a very powerful and valuable imaging technique that can provide important and even lifesaving information. Sometimes, however, imaging tests like ultrasound and magnetic resonance imaging (MRI) can provide the same information as CT but not expose your child to any radiation. You should ask your doctor and imaging provider whether these alternatives are appropriate for your child’s situation. If a CT is the best test, make sure that your imaging provider uses appropriate low dose techniques to minimize radiation exposure during the test.

How can I be sure that my medical imaging facility is using appropriate reduced radiation techniques?
Some facilities that perform CT scans on adults do not use radiation dose reduction techniques when scanning children. You won’t know unless you ask, and it is reasonable and within your rights to do so. Your imaging provider should be able to provide you with information about what they do to reduce radiation doses during CT. Other things to ask about include whether the facility has American College of Radiology accreditation, whether the CT technologists are credentialed and if the person interpreting the studies is a board certified radiologist or pediatric radiologist.

Is there an increased risk of cancer from medical radiation, especially CT scans?
While no one can point to a single individual and say that their cancer was caused by medical radiation, there is evidence that exposures to radiation levels found during CT scans may slightly increase the risk of future cancer. The risk for developing cancer is debated and variable, and may be zero, but estimates also range from about one in 500 to one in 10,000 fatal cancers from a single CT scan. This needs to be interpreted against the risk of developing cancer over one’s lifetime. Since the risk of developing cancer in an individual is about one in five during a lifetime, the extra risk from CT is very small.  

Who should I talk to about my medical imaging concerns?
Any discussion should start with your child’s physician. They will know or can inquire if the imaging center to which they refer utilizes appropriate pediatric CT scanning techniques and if a non-radiation imaging test might be as useful for your child’s situation.  If not, you should ask to speak with the technologist or radiologist at your imaging facility so that your concerns and questions can be answered. 

About Medical Imaging

The department of medical imaging (radiology/nuclear medicine) at Dayton Children’s offers a full spectrum of diagnostic imaging for pediatric patients. The pediatric specialists are trained in working with infants, children and teenagers, and personnel are highly skilled in sedating infants and young children. The radiology department has state-of-the-art equipment designed to perform diagnostic examinations with a minimum of radiation exposure to patients. An onsite MRI is available, offering the highest quality images with child-friendly features. A parent can be with their child while he or she is being scanned and children are encouraged to bring their own music or stories to be played on the specially designed sound system. Appointments are available to meet most family's needs. Beginning in late fall 2008, Dayton Children’s Vandalia Testing Center will offer basic x-ray, ultrasound, exchocardiograms and EKG testing.


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