STUDY: Children more sensitive to radiation than adults, experts warn

JOURNAL: National Cancer Institute and Society for Pediatric Radiology

AUTHORS: Dr. Tom Slovis

ABSTRACT: Too many kids are needlessly exposed to the scans’ radiation, say specialists developing new guidelines that aim to cut by a third unnecessary CT scans of children’s brains

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COMMENTARY: CT SCANS are computer-enhanced X-rays that can provide a better view of all parts of the body, not just the brain — have revolutionized medicine. But the scans, more popularly known as CAT scans, do emit significantly more radiation than a standard X-ray, and children are more sensitive to radiation than adults.

Yet with the number CT scans increasing sevenfold in the last decade, up to 3 million a year now are being performed on U.S. children. There’s little guidance on when they’re truly necessary or when other exams will do.

So specialists have begun a nationwide effort to curb unnecessary child CT scans — and ensure that when one is needed, hospitals use a child-appropriate radiation dose instead of the higher adult dose too often used.

Radiation from a single CT scan still is relatively low — and certainly not high enough to warrant skipping a scan if a child may be seriously ill or injured, such as after a car crash, specialists warn.

Recent research suggests lower radiation doses than once thought — as low as 10 to 20 REMs — may somewhat increase people’s risk of getting cancer decades later. Exposure is cumulative, and children are likely to need numerous exams over the course of their lives that will add up.

Simply adjusting the dose can lower children’s radiation absorption. For example, a child given a typical adult-dose brain CT scan will absorb 6 REMs of radiation, and 2 to 3 REMS for abdominal CT. Adjust the scanner to a pediatric setting, and that child will absorb 3 REMS from a brain CT and 0.6 REMS to the abdomen. (A standard chest X-ray, in contrast, provides about 0.01 REM.)

CT scans are needed if children have any of the following risk factors: is age 2 or younger; has a skull fracture or deformity; has a bicycle-related injury; is dizzy, has a behavior change or problems with vision or other senses; or scores less than 15 on a standard neurological exam called the Glasgow Coma Score.