Dayton Children’s cuts risk from CT scans

Dayton Children’s Hospital has joined dozens of hospitals and imaging facilities across the country in adopting new scanning technology that dramatically lowers doses of potentially cancer-causing radiation.

Radiation exposure from computed tomography examinations, commonly referred to as CT scans, is a concern in both adults and children. But children and infants present unique challenges because their still-developing bodies are more sensitive to radiation, experts say.

As a result, the risk for developing a radiation-related cancer can be several times higher for a young child than an adult, according to the National Cancer Institute, which estimates as many as 9 million CT examinations are performed annually on children in the United States.

That includes about 3,500 CT scans performed annually at Dayton Children’s, according to hospital officials.

“As pediatric radiologists, we are very aware that radiation exposure has small risks, and that these risks are greatest in children because of their growing cells, small size, and longer life expectancy,” said Dr. Elizabeth Ey, director of medical imaging at Dayton Children’s. “Anything we can do to reduce radiation exposure in medical imaging is important, especially in small children.”

The hospital said it spent $200,000 on new imaging software, called AIDR 3D, that can reduce radiation exposure from CT scans by as much as 80 percent, while at the same time maintaining a quality image. The radiation dose reduction is greatest when imaging the neck, chest, and abdomen, officials said.

“There is a limit to how low a radiation dose can be used and still get a diagnostic image. If the dose is too low, there won’t be enough information to make a clear image,” explains Ey. “The new CT upgrade allows a lower dose than what we have been using thanks to more sophisticated software that can create as clear an image as before with less information and hence less radiation.”

But even with low-dose technology, CT scans should be performed only when necessary to keep radiation doses as low as possible and avoid repeated exposure, said Dr. Marilyn Goske, a pediatric radiologist at Cincinnati Children’s Hospital Medical Center and chair of The Alliance for Radiation Safety in Pediatric Imaging, which represents pediatric radiologists worldwide.

“CT scans do save lives, but we want to use them wisely,” she said.

To raise awareness, the alliance in 2007 launched an “image gently” campaign encouraging doctors and hospitals to commit to lowering radiation doses from imaging scans. More than 22,000 individual doctors and an unknown number of hospitals have signed onto the pledge, including Dayton Children’s.

“What that tells us is that the message is starting to get out there and actually changing patients’ care,” Goske said.

Dayton Children’s also recently added two new pulsed fluoroscopy radiology units, which are more sensitive and can require less than half the radiation to produce a clear image, according to the hospital.

Fluoroscopy is a method of “real time’ X-ray” that allows radiologists to see movement, rather than one still image, according to a news release. Fluoroscopy is frequently used to see movement during swallowing, to evaluate for proper drainage of urine from the bladder, and to evaluate the position and movement of bowel.

“We constantly seek to learn new and better ways to image children, keeping their health and welfare above all else,” said Ey. “We consider each child and their condition individually in order to perform the most appropriate imaging study.”

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