Reducing radiation exposure to children from unwarranted CT scans

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The Australian Commission on Safety and Quality in Health Care (the Commission) has developed improved resources for parents and carers, referring clinicians, and other healthcare professionals involved in paediatric CT imaging.

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In Australia, recent data show there are over 80,000 computed tomography (CT) scans performed annually on children and young people under the age of 20^[1]. [pull quote] CT is a valuable diagnostic tool of benefit in a wide range of clinical situations. However, the higher level of ionising radiation used in CT compared to other types of imaging and their use in childhood or adolescence has been linked to a slight increase in developing cancer later in life, with one extra case of cancer estimated for every 1,800 scans^[2].
It is important to ensure that CT scans are undertaken for time-critical conditions and when there are evidence-based protocols for conditions or disease - for example in cases of serious head trauma - CT scans may provide important diagnostic information to the clinical team in a hospital’s emergency department. However, children and young people are more sensitive to ionising radiation because their bodies are still developing, so consideration needs to be given to whether:

• an immediate CT scan will improve the child’s healthcare


• previous imaging is available that could provide the information needed


• there are other imaging options that could be used


• a justified CT scan be done using a ‘kid-sized’ radiation dose


• the benefits and risks have been explained to parents and carers.

New resources
In partnership with other organisations, the Commission has produced a number of resources for parents and carers, referring clinicians (including GPs, medical specialists and dentists) and medical imaging service providers. These resources include:

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  ‘What you need to know about CT scans for children’ – a brochure for parents and carers containing information on CT scans, the benefits and risks, and how exposure might be reduced. This brochure could support a conversation between doctors and consumers about CT scans and their child’s care.


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  ‘Talk to your doctor about CT scans for children’ – a poster for display in waiting rooms covering questions parents and carers might ask.


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  ‘CTs and children: information for referrers’– a fact sheet for doctors containing information about CT-related radiation exposure, the increased risk of radiation exposure in children and young people and the importance of explaining benefits and risks to patients, parents and carers.


• A consumer brochure and companion poster on cone beam CT as used in oral health care have also been produced for dentists and dental specialists.

Partnership with Australian Institute of Radiography
The Commission also partnered with the Australian Institute of Radiography to undertake a survey of Australian radiographers, and subsequently identified strategies to support radiographers in the technical aspects associated with undertaking paediatric CT scans, through an online learning module.
More information
For more information, including links to these and other resources about CT scans and children and young people visit www.healthdirect.gov.au@ctscansforkids or www.safetyandquality.gov.au/ctscansforkids

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References
1. 2013/14 Medicare data. Figures include cone beam CT used by dental practitioners.
2. Mathews JD et al. “Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians”. BMJ.2013;346:2360.

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“In Australia, recen data show there are over 80,000 computed tomography (CT) scans performed annually on children and young people under the age of 20 ^[1].”

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