Image Gently: progress and challenges in CT education and advocacy

Abstract

Significant progress has been made in radiation protection for children during the last 10 years. This includes increased awareness of the need for radiation protection for pediatric patients with international partnerships through the Alliance for Radiation Safety in Pediatric Imaging. This paper identifies five areas of significant progress in radiation safety for children: the growth of the Alliance; the development of an adult radiation protection campaign Image Wisely™; increased collaboration with government agencies, societies and the vendor community; the development of national guidelines in pediatric nuclear medicine, and the development of a size-based patient dose correction factor by the American Association of Physicists in Medicine, Task Group 204. However, many challenges remain. These include the need for continued education and change of practice at adult-focused hospitals where many pediatric CT exams are performed; the need for increased emphasis on appropriateness of pediatric imaging and outcomes research to validate the performance of CT studies, and the advancement of the work of the first pediatric national dose registry to determine the "state of the practice" with the final goal of establishing ranges of optimal CT technique for specific scan indications when imaging children with CT.

The Use of Adaptive Statistical Iterative Reconstruction in Pediatric Head CT: A Feasibility Study

“…3 For these reasons, the Alliance for Radiation Safety in Pediatric Imaging has worked to minimize unnecessary radiation doses for children, particularly through their Image Gently educational and awareness campaign. 4 A recent study examining the use of CT in child visits to the emergency department in the United States from 1995 to 2008 found a substantial and sustained growth in the use of CT during this time. The 2 most commonly recorded conditions for visits in which CT scanning was performed were "head injury" followed by "headache".…”

CT radiation dose reduction: can we do harm by doing good?

“…In September 2011, Pediatric Radiology published a supplement containing the contents of a recent ALARA conference [1][2][3][4][5][6][7][8][9][10]. One month later, Radiology published an editorial titled "CT radiation dose: trending in the right direction" [11].…”

“…There is now widespread awareness of the risks of cancer from radiation [2,4,7]. Large alliances have been formed [2][3][4]; extensive education programs on radiation dose reduction have been created [1,2,11] and there are new government regulations [3]. There are many conferences on radiation safety, with the 6th ALARA conference occurring in 2011.…”

“…There are many conferences on radiation safety, with the 6th ALARA conference occurring in 2011. Better methods for estimating actual patient dose are being suggested, as the limitations of indices such as CTDI and DLP are being taught [1,3,5,6]. Population dose is being decreased with reduction of inappropriate studies and formulation of appropriateness criteria [1,4,7,9,10].…”

“…As several excellent articles in the supplement discuss, there is no accurate method of measuring the actual radiation dose that is given to a patient during a CT study [1,5,6]. The role and limitations of the CT dose indices and the methods of determing an estimated dose are very well presented [1,3,5,6].…”