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Child Scan Solution: Same Slices Don’t Fit All

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Pediatric neuroradiologists and neurosurgeons at the Johns Hopkins Children’s Center in Baltimore have come up with a deceptively simple way to reduce radiation exposure in children who must undergo repeated CT scans of the brain: fewer slices.

From previously performed head CT scans with the standard number of slices, the researchers extracted sequences of seven axial slices. Two pediatric neuroradiologists and a pediatric neurosurgeon then blindly and retrospectively reviewed those limited-sequence scans. Had the scanner taken only those slices, according to an article about the technique published online last week in the Journal of Neurosurgery: Pediatrics, it would have reduced radiation exposure by an average of nearly 92 percent per patient while still creating images adequate for accurate diagnosis.

Lead investigator and lead author Jonathan Pindrik, MD, summarized thus:

The traditional thinking has been that fewer slices would, by definition, mean less clarity and less accuracy, rendering a CT scan suboptimal, but our findings show otherwise.

Dr. Pindrik is chief neurosurgery resident at Johns Hopkins. He was quoted in a children’s center news release.

The research involved children with hydrocephalus, which requires periodic surgeries to drain excessive fluid from the brain. A head CT precedes each such procedure. With all 50 patients, ages 17 and younger, the limited-slice technique produced clear and accurate images of the brain ventricles that carry cerebrospinal fluid in and out of the brain. However, the low-dose scans did result in a 4 percent error rate in showing changes in ventricle size.

Senior author Edward Ahn, MD, a pediatric neurosurgeon at the children’s center, declared victory. “We have been searching for ways to minimize radiation exposure in kids without sacrificing the diagnostic accuracy of the images, and that is no easy feat,” Dr. Ahn said, “but we believe our limited-slice CT scans achieved that balance.”

Related CME seminar (up to 27 AMA PRA Category 1 credits): Pediatric Radiology

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