Image gently for teenagers, too

As I’ve written before, rapid increases in the use of medical imaging, especially CT, have led to alarming increases in radiation exposure in addition to the financial cost. This is a particular issue for kids, especially since they often receive radiation doses that are needlessly high. Initiatives such as Image Gently are doing their best to educate physicians on the need to use lower settings for kids.

However, even radiologists who know not to dose young kids with adult-strength radiation settings may not realize the need to be careful with teenagers as well. According to AuntMinnie (Smaller teens sometimes get adult-sized CT dose, study finds) teenagers often receive adult levels of radiation despite smaller body sizes.

“This discovery was unexpected and alarming, considering that more than 50% of teenage children who receive CT exams at [the Medical University of South Carolina] don’t have the body mass of a fully formed adult,” said Dr. Dobrinka Dimitrova, a radiology resident, during her scientific poster presentation…

“Above the age of 12 years, kV and mAs are standardized to fully formed adult bodies,” Dimitrova said. “Because children over the age of 12 have different growth rates, a 15-year-old girl, for example, may have a body size comparable to a 10-year-old. She may receive a lot higher dose than needed because the set parameters are for adults.”

“Some of the CT scans I’ve investigated have as much as 25 mSv of radiation dose. Two of these will put a pediatric patient into a category of high incidence of solid tumors or lymphoma. [Emphasis mine.] Radiologists need to be the gatekeepers to protect children from unnecessary and excessive radiation dose.”

This is a major issue for the medical community. Until things are sorted out parents should respectfully challenge radiologists who suggest CT scans. It may be an uncomfortable thing to do,  but your kid may thank you later.

December 11, 2008

One thought on “Image gently for teenagers, too”

  1. I continue to be very upset by having had two scans of my abdomen (afer a nuclear medicine test of my gallbladder) which where not necessary and which I would have never had if I had been educated on the radiation dose prior to the procedures. Not to mention how upsetting the lack of professionalism and ignorance on this issue which I have encountered with the imaging center when trying to get information. I was never even told I was having two scans by my doctor or the radiologist. The abdomen and pelvis scans deliver the highest doses of radiation out of all CT scans, and I have had both, in fact it appears to be the highest dose you can get in all of radiology – an order of magnitude greater than most other radiology procedures. I have done a lot of research in I think some kind of attempt to alleviate my concern, but the more I have read, the more concerned I have become. It seems inescapable that I have been potentially been exposed to the equivalent of approximately 1000 chest x-rays (wow) or radiation surpassing the exposure to someone that was underneath an atomic bomb detonation, and now I have statistically increased my odds of not only developing radiation induced cancer, but dying from that cancer – this is nothing short of shocking. What is so upsetting is that the damage/exposure from the radiation is irreversible….so there is this kind of gnawing frustration. If I had come into an emergency room in an ambulance, then it would be understandable, but these two scans along with the nuclear medicine scan that they gave me a year earlier add up to a ridiculous unnecessary exposure… upsetting.

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