Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Kids frequently exposed to imaging procedures that use radiation

04.01.2011
Parents, doctors should educate themselves and be cautious about the frequent use of these diagnostic tests for kids
Meet the experts:
Adam L. Dorfman, M.D.
Brahmajee K. Nallamothu, M.D., M.P.H.
Learn more:
C.S. Mott Children's Hospital
Department of Pediatrics and Communicable Diseases

The rapid growth in use of medical diagnostic imaging, such as CT scans, has led to widespread concern about radiation exposure in adults and the potential for future cancer risk in patients undergoing these tests.

A new study led by University of Michigan researchers now shows that kids also frequently receive these types of imaging procedures during their routine clinical care, and highlights the importance of initiatives to ensure that those tests being performed are necessary and use the lowest possible doses of radiation.

“Our findings indicate that more awareness about the frequent use of these tests may be needed among care providers, hospitals and parents,” says Adam L. Dorfman, M.D., clinical assistant professor of pediatrics and communicable diseases and of radiology at the U-M Medical School. “Imaging tests are a critical component of good medical care, but the high number of tests raises questions about whether we are being judicious in our use of the technology.”

The results of this study were published online today in the Archives of Pediatrics and Adolescent Medicine.

Despite widespread discussions about the health hazards of environmental exposures in children, radiation exposure from the frequent use of imaging procedures has received less attention, possibly due to limited contemporary data in younger patients. As such, this study identified 355,088 children under the age of 18 in five large U.S. health care markets to track how often these imaging procedures are used. The study found that over 400,000 imaging procedures were performed in just 3 years, with 42.5% of the children receiving at least one of these procedures and many undergoing multiple tests. The types of tests the investigators considered included everything from routine x-rays that use very low doses of radiation to more advanced tests, like CT scans, that require doses that are greater. Based on these data, the average child in this study population would be expected to receive approximately 7 imaging procedures utilizing radiation by age 18.

By necessity, the study focused on the numbers and types of procedures that were performed, and did not calculate specific doses of radiation that were received by each child. Data to perform such calculations are limited in children and are part of ongoing work by the team.

“What we’ve tried to do is raise awareness of the issue and start a national dialogue by identifying the overall scope of the problem,” Dorfman says.” One limitation of this type of analysis is that the clinical appropriateness of the tests could not be determined, he adds.

“The next step is to better understand when these tests really add value to the care of a child and when they do not,” Dorfman says.

Among the tests that the investigators considered, CT scans are the most important from the standpoint of radiation exposure. Nearly 8% of the children in this study received a CT scan in the 3-year study period, with 3.5% of the children receiving more than one. Understanding patterns of utilization of these tests in children is important because children and infants are more susceptible than adults to the risks of radiation exposure, such as future cancers.

“Developing tissues in children are more sensitive to radiation and their longer expected life spans also allows additional time for the emergence of detrimental effects,” says co-author, Reza Fazel, M.D., M.Sc., a cardiologist at the Emory School of Medicine. Fazel cautions that for any individual child undergoing a single test the risk is typically low.

“Of course, there is immense life-saving value in medical imaging, so our study doesn’t suggest at all that these tests shouldn’t be used in children,” adds co-author Kimberly E. Applegate, M.D., vice chair for Quality and Safety in the Department of Radiology at Emory University. “We have to be smarter about how we use tests. For example, children don’t always need the same radiation dose during a CT scan to get the same quality of image and information.”

Investigators note that each imaging procedure should be guided by the principle of ALARA, or As Low As Reasonably Achievable, which advocates for minimizing radiation doses while still obtaining sufficient clinical information. Applegate, a member of the international Image Gently Campaign, is working with a coalition of health care organizations to raise awareness of the need to adjust radiation doses when imaging children. The Image Gently campaign promotes optimal scanning strategies to lower radiation exposure in children.

Andrew J. Einstein, M.D., Ph.D., a cardiologist at Columbia University and another coauthor, says this study should not deter parents from imaging procedures that may provide clear benefit for their children. “It should encourage discussions about the value of each imaging test that is ordered, recognizing that radiation exposure, even in small amounts, may not be risk free.”

Additional authors include Harlan M. Krumholz, M.D, S.M., Yale University School of Medicine; Yongfei Wang, M.S.,Yale University School of Medicine; Emmanuel Christodoulou, Ph.D., University of Michigan Medical School; Jersey Chen, M.D., M.P.H., Yale University School of Medicine; Ramon Sanchez, M.D., University of Michigan Medical School; Brahmajee K. Nallamothu, M.D., M.P.H., University of Michigan Medical School

Funding: Dr. Einstein was supported by K12 institutional career development award KL2 RR024157 from the National Institutes of Health, by the Louis V. Gerstner Jr Scholars program, and by the Lewis Katz Cardiovascular Research Prize for a Young Investigator. Dr. Chen was supported in part by American Heart Association Clinical Research Program Award 10CRP2640075 and Agency for Healthcare Research and Quality Career Development Award 1K08HS018781-01.

Disclosure: Dr. Einstein has served as a consultant for the International Atomic Energy Agency and for GE Healthcare, has received support for other research from Spectrum Dynamics and a Nuclear Cardiology Foundation grant funded by Covidien, and has received travel funding from GE Healthcare, INVIA, Philips Medical Systems, and Toshiba America Medical Systems. Dr. Applegate has a textbook contract for Evidence-Based Imaging in Pediatrics with Springer. Dr. Krumholz is the chairman of a scientific advisory board for UnitedHealthcare.

Additional Resources: The Image Gently Campaign is an initiative of the Alliance for Radiation Safety in Pediatric Imaging. The campaign goal is to change practice by increasing awareness of the opportunities to lower radiation dose in the imaging of children. More information at: www.imagegently.org

Ref: DOI: 10.1001/archpediatrics.2010.270.

Written by Margarita B. Wagerson

Margarita B. Wagerson | EurekAlert!
Further information:
http://www2.med.umich.edu/prmc/media/newsroom/details.cfm?ID=1878

More articles from Health and Medicine:

nachricht NIST scientists discover how to switch liver cancer cell growth from 2-D to 3-D structures
17.11.2017 | National Institute of Standards and Technology (NIST)

nachricht High speed video recording precisely measures blood cell velocity
15.11.2017 | ITMO University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: A “cosmic snake” reveals the structure of remote galaxies

The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.

Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...

Im Focus: Visual intelligence is not the same as IQ

Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.

That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...

Im Focus: Novel Nano-CT device creates high-resolution 3D-X-rays of tiny velvet worm legs

Computer Tomography (CT) is a standard procedure in hospitals, but so far, the technology has not been suitable for imaging extremely small objects. In PNAS, a team from the Technical University of Munich (TUM) describes a Nano-CT device that creates three-dimensional x-ray images at resolutions up to 100 nanometers. The first test application: Together with colleagues from the University of Kassel and Helmholtz-Zentrum Geesthacht the researchers analyzed the locomotory system of a velvet worm.

During a CT analysis, the object under investigation is x-rayed and a detector measures the respective amount of radiation absorbed from various angles....

Im Focus: Researchers Develop Data Bus for Quantum Computer

The quantum world is fragile; error correction codes are needed to protect the information stored in a quantum object from the deteriorating effects of noise. Quantum physicists in Innsbruck have developed a protocol to pass quantum information between differently encoded building blocks of a future quantum computer, such as processors and memories. Scientists may use this protocol in the future to build a data bus for quantum computers. The researchers have published their work in the journal Nature Communications.

Future quantum computers will be able to solve problems where conventional computers fail today. We are still far away from any large-scale implementation,...

Im Focus: Wrinkles give heat a jolt in pillared graphene

Rice University researchers test 3-D carbon nanostructures' thermal transport abilities

Pillared graphene would transfer heat better if the theoretical material had a few asymmetric junctions that caused wrinkles, according to Rice University...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Ecology Across Borders: International conference brings together 1,500 ecologists

15.11.2017 | Event News

Road into laboratory: Users discuss biaxial fatigue-testing for car and truck wheel

15.11.2017 | Event News

#Berlin5GWeek: The right network for Industry 4.0

30.10.2017 | Event News

 
Latest News

NASA detects solar flare pulses at Sun and Earth

17.11.2017 | Physics and Astronomy

NIST scientists discover how to switch liver cancer cell growth from 2-D to 3-D structures

17.11.2017 | Health and Medicine

The importance of biodiversity in forests could increase due to climate change

17.11.2017 | Studies and Analyses

VideoLinks
B2B-VideoLinks
More VideoLinks >>>