Tuesday, June 11, 2013

4 Questions to Ask if Your Child's Doctor Recommends a CT Scan

You may have seen on the news that a new study was just published in the journal JAMA Pediatrics, reviewing how radiation doses from CT scans need to be adjusted even more and done even less frequently on children in order to lower their risk of developing radiation-related cancer later on in life. The researchers  discussed how children are smaller than adults and don't need as much radiation for their CT images as do adults, among other issues. This finding, of course, makes sense.

The study goes on to say that by reducing radiation doses and reducing unnecessary exams, the long-term cancer risk for children who have these tests could drop as much as 62 percent. We do know that exposure to radiation, even from medical exams like CT scans (also called CAT scans) can increase a person's later-in-life risk of developing some sort of cancer. Fortunately, as technology is adapted and more is learned, newer guidelines and modern scanners are providing for less radiation exposure than ever before, particularly among children.

Of course, we want to do everything we can to reduce any risk of our children of causing cancer, but it is important to understand that as impressive (and important) that 62 percent reduction in risk is, the chances of developing radiation-caused cancer are low to begin with. That's not to say it doesn't happen, it does. But it isn't common, so this needs to be kept in mind when looking at the numbers.

So, why is this study important? It's a reminder that not all CT scans that are ordered may be necessary. It's a reminder that not all facilities that do these scans on children are using calculations that are appropriate for their pediatric patients' size. And it's a reminder that we need to ask questions and understand why tests are being done on our children.

The American College of Radiology released a statement yesterday, in response to the study, in which it said: "Diagnostic scans reduce the number of invasive surgeries, unnecessary hospital admissions, and the length of hospital stays. However, they must be used judiciously, when indicated, and when the needed information cannot be obtained in other ways, in order to minimize radiation exposure to all Americans - particularly children.

Keeing this all in mind, what is a parent to do? There are four questions that parents should ask when a doctor recommends that their child undergo a CT scan:

1- What benefit will there be from having this scan performed? (Why do it?)

You want to know what the doctor is looking for and why the CT scan is the right test for this.

2- Is there any other exam that would be equal to or better than a CT scan?

You want to learn if a regular x-ray or an MRI, which doesn't use radiation, could be be performed instead of the CT scan with equal or better results.

3- Will the radiation dose be adjusted to account for my child's size?

One issue that affects radiation exposure is that not all tests are properly calibrated for children, particularly if the facility does not see many pediatric patients and are not experienced in dealing with children of various ages and sizes.

4- Is the facility ACR accredited?

The ACR accreditation involves surveying of medical imaging equipment to assess that it meets industry standards and that the radiologists who are interpreting the findings are qualified to do so, reducing the chances of more exams being ordered on the same patients.

There is no doubt about it. Exams such as CT scans do save lives. But we need to be sure that the people doing these tests are doing them properly, that the equipment is maintained properly at at the most recent standards, and that the proper exams are being ordered for the right reasons.

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