In the field of radiology, it is critical to follow all safety precautions and departmental policies. And with pediatric imaging, doctors must be extremely careful with radiation doses, because of the sensitivity of children's rapidly dividing cells. With adults, cells still divide, but at a much slower rate. Computed Tomography, or CT scans, and X-rays both use ionizing radiation that has the potential to cause mutations in the DNA strands of dividing cells. According to the United States Nuclear Regulatory Commission, ionizing radiation could cause cancer and other biological effects.
ALARA
When it comes to safety, radiology technologists are taught to do their jobs using the ALARA principle: a dose that is as low as reasonably achievable. This means that the dose of radiation should not be more than what is needed to provide a quality radiograph for a radiologist to read. Determining the proper dose for each patient requires skilled training.
Shielding
When radiation is used, the patient should be shielded to block radiation from reaching body parts that do not need to be imaged. The shielding is usually lead that lines the inside of a piece a fabric or material. For an X-ray, this is relatively simple; the shield is placed over the reproductive body parts and possibly the thyroid if these areas are not being imaged. In CT, the radiation tube rotates around the patient during the scan, so shielding should surround the body if possible.
Motion
Children can be the most difficult patients to image, because they sometimes are reluctant to hold still. The result can be motion artifacts, or blurred images, rendering an image that's not usable for diagnosis. Most children can remain still for an X-ray, because the exposure time usually lasts less than a second. However, CT exposure could last 6 to 12 seconds or longer, depending on the body part imaged and the machine used. It's critical for young patients to stay still so repeat exposures are not necessary.
Limit Exams
When it comes to children, less is more. X-rays should be coned down to only view the area of interest. For example, if a wrist X-ray is ordered, the image should not include the forearm and hand unless the physician requests that. A CT should not scan more than the area of interest, and the goal should be to do only one scan. For example, some abdomen and pelvis studies could be ordered as abdomen only. Also, delay scans should be avoided unless absolutely necessary. Ask questions if you are concerned about the safety of a scan on your child.
Increase Awarenes
The overall goal with radiation and children is to increase awareness among professionals, parents and everyone else involved in their care. That's the focus of image gently, a campaign by the Alliance for Radiation Safety in Pediatric Imaging. The organization points out that doctors order more than 7 million CT scans a year for children, with a 10 percent increase each year.
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