Our children’s hospital, along with many others, has made a concerted effort to reduce radiation exposure by adjusting CT scan settings. Even a single abdominal CT scan may confer a small but real risk of developing cancer. The trade-off with low-dose CT techniques has been a concern about poor image quality. New research indicates that low-dose CT scan is not inferior to standard-dose CT with respect to detecting appendicitis (NEJM 2012; 366: 1596-605).
This single-center study examined 441 patients assigned in a single-blind fashion to low-dose CT (median dose: 116 mGy-cm) in comparison to 447 patients receiving a standard-dose CT (median dose: 521 mGy-cm). All patients had CT for suspected appendicitis. The negative appendectomy rate was 3.5% in the low-dose group and 3.2% in the standard-dose group. There was no significant difference in appendiceal perforation rate or proportion of patients needing more imaging.
How much radiation do your patients receive with a CT scan?
Related newspaper article:
FDA issues guidelines to lower radiation exposure in children:
Magnetic resonance enterography for Crohn’s disease
- -NEJM 2010; 363: 1, 4. Safety of CT. Can have overdose of radiation and even standard doses could cause complications. Also, a big issue is downstream unnecessary testing due to incidental findings.
- -JPGN 2011; 52: 280. Documents high exposure to radiation in large IBD pediatric cohort.
- -J Clin Gastroenterol 2011; 45: 34-39. High levels of ionizing radiation thru CT scan in pts with IBD.
- -Pediatr Radiology 2002; 32: 217-313. Minimizing radiation exposure, risk/benefit of CT. Proceedings from conference.
- -Pediatr Radiology 2002; 32: 700-706. Risk of CT for young child: ~ 1 in 1000 risk of fatal cancer later in life.
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