[Radiology] Is a CT scan for children safe ?

radiologist (57)in #health • 6 years ago (edited)

After the Nuclear accident in Fukushima, many people are worrying about radiation.
It is now well-known fact that that excessive radiation is not good for your body.
When the doctor asks your child to get a CT scan, you may be worried as follows:

Q : Doesn't CT scan have radiation? Is a CT scan for children safe?

Today, let's talk about this issue.

Why should children be more careful?

The younger the child, the greater the risk of radiation.
In growing child’s body, cells are actively dividing, so they are more sensitive to radiation than adults. The child’s body size is so small that even the same amount of radiation can affect the body more than the adult. In addition, since the remaining life is long, the possibility of cancer is higher. Moreover, children are more likely to be exposed to radiation several times due to trauma, health checkups, and illnesses while growing. Also, girls are twice as sensitive to radiation as boys are, especially with their thyroid, bone marrow, reproductive organs, and lens.

Do the children need to get a CT?

The best way to prevent radiation damage is to avoid a CT scan, of course. Therefore, in many hospitals, if the child needs examination, doctors use ultrasound or MRI which does not have a risk of radiation. However, because each test has different strengths, a CT scan is inevitably needed sometimes. For example, CT is best for accurate diagnosis of intracranial hemorrhage, fractures, and respiratory problems. To conclude, If it is considered more beneficial than harm from radiation exposure, the implementation of a CT scan is justified.

If the child gets a CT, is it different from the adult?

You may be surprised when you go to the pediatric CT room. There are cute pictures and characters on the walls and ceiling. This is to prevent re-scanning due to incomplete examination. If necessary, the child may be scanned under the care of parent. Doctors are technically minimizing CT scan coverage and radiation exposure, as long as they do not decrease the quality of the images through machine manipulation. If sensitive organs are involved inevitably, a radiation shield is attached in order to prevent radiation transmission. In this way, the amount of radiation is minimized.

The pediatric CT room with cute decoration.
From AntonioLeonMexico, https://commons.wikimedia.org/wiki/File:HITO3.jpg

Radiation shield for gonad.
From Ref. #5

Is there any guideline for radiation dose in children?

There is an ICRP proposal on dose limits. According to ICRP, the general using of radiation is limited, but there is no limit to the dose for medical purposes. However, it is prescribed that using of radiation should be always more beneficial than harm, and the doctor has the responsibility for medical radiation exposures. In some countries, there are radiation dose guidelines. These guidelines contain recommendations and standards about radiation dose in children.

To conclude….

Children are weak and vulnerable for radiation. So, in many cases, ultrasound or MRI is used instead of CT. However, if the child gets a CT scan, it is because that there are more diagnostic benefit than damage from radiation. You should remember this, many radiologists are trying to reduce radiation in various ways. If more research on low-dose CT is made and the development of radiation dose reduction technique is advanced, the worry about radiation will be reduced more and more, and I think that we can get a CT scan more reliably. Fin.

A: Don’t worry! Getting a CT scan is more helpful to a child

Reference

(Korean) 서울대학교병원 영상의학과 등. 연수 강좌 소아영상진단. 2014.
(Korean) 정아영. 소아촬영의 방사선 피폭과 저감화 방법. J Korean Med Assoc 2011 December; 54(12): 1277-1283.
UNSCEAR 2013 Report. Volume II SCIENTIFIC ANNEX B: Effects of radiation exposure of children.
ICRP, The 2007 Recommendations of the International Commission on Radiological Protection, Ann. ICRP 37 (2-4), 2007.
Lawrence T Dauer et al. Radiation dose reduction at a price: the effectiveness of a male gonadal shield during helical CT scans. BMC Medical Imaging 2007, 7:5. [CC-BY]

Images without source; from Shutterstock.