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UN Warns About CT Scan Danger For Kids

May 3, 2010
Written by: , Filed in: Pediatric Radiology
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A United Nations agency is warning that children in some developing countries are still receiving too much radiation during CT scans—including adult-size exposures instead of child-size doses. Apparently, most of the medical facilities doing so just don’t realize the risk, despite warnings against the practice going back more than a decade.

The International Atomic Energy Agency studied 128 health-care facilities in 28 developing countries in Africa, Asia, and Eastern Europe. It found wide variation in radiation levels and frequency of CT scans performed on children under age 15.

The study found 11 facilities in six countries that were using adult exposure guidelines for children. Dr. Madan Rehani, IAEA radiation safety specialist, coordinated the study. He said that in most cases, the operators didn’t know they were doing anything wrong. Sometimes, the machine settings were correct, but the operators scanned more of the patient’s body than was necessary. And developing countries often use older CT machines that lack automatic exposure controls that adjust for the thickness of the body being scanned.

Dr. Rehani pointed out that with CT scans, it’s difficult to tell the level of exposure from the image itself:

With these scans, if the exposure is too high, the image does not deteriorate. In fact, it tends to look better. This is in contrast to the conventional X-rays, (where) if the exposure is slightly higher, the image goes black.  So you know you’ve given a higher radiation dose than required.

Fortunately, all 11 facilities “reacted positively” when told of the problem and are changing their procedures, said Dr. Rehani. “The radiation doses are being reduced,” he said. “So this is an ongoing process of increasing awareness about correct exposure factors.”

The IAEA is trying to improve radiation protection for patients around the world. It says that medical procedures constitute the fastest-growing source of ionizing radiation exposure to humans. “In many situations, the benefits outweigh the risks,” said Dr. Rehani, but unnecessary radiation obviously needs to be avoided.

Experts have been concerned about children’s radiation doses for some time. As Dr. Rehani pointed out, children are more sensitive to radiation than adults. And they have longer to live, which means that there’s more time for cancer to develop as a result of radiation exposure. The IAEA has recently begun working with Image Gently, a U.S.-based campaign to protect children from excess radiation that was launched in 2008 by the Alliance for Radiation Safety in Pediatric Imaging.

“It’s clear that the mission of our two groups is strongly aligned,” said Marilyn J. Goske, MD, chairperson of the alliance and a professor of radiology at Cincinnati Children’s Hospital Medical Center. “We’re both dedicated to radiation protection for patients and, in particular, children.”

Related seminar: Pediatric Radiology Review

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