As a pediatric radiologist, I am often asked by parents about imaging tests for their children that use medical radiation. This is important and I firmly believe that parents should advocate with their pediatricians for the well being of the child. I am also a parent and this gives me some perspective as a pediatric radiologist to address important questions that parents should ask, and what answers they should expect.
Here are important questions to ask your pediatric radiologist:
What is the name of the medical imaging test and what is the purpose for obtaining this test?
Parents and patients should have a good understanding of which test is being performed and for which indication. I find it very helpful when parents are prepared before the day of imaging with some understanding as to what their child might experience and also what the doctor hopes to find (or not find) with the imaging test.
Does the test use radiation to create the image?
Common imaging exams that use medical radiation are Computed Tomography (CT), Fluoroscopy, X-ray, and Nuclear Medicine (NM) studies. Each study uses different amounts of medical radiation depending on the indication and the size of the child. A detailed discussion of each is beyond the scope of this post, but the Image Gently website provides a detailed discussion of each of these modalities under the “resources for patients” section.
Are there other tests or actions that could be substituted for this test?
CT, Fluoroscopy, NM, and X-ray studies provide a significant amount of useful information. However, given that what we do in children will last their lifetime, and that children have a higher sensitivity to radiation than adults, we should be judicious in our use of medical radiation. Sometimes an alternative radiation free examination such as Ultrasound (US) or Magnetic Resonance Imaging (MRI) can provide similar information. However, often different imaging tests are complementary. There are also times when a test that uses radiation is the only means to provide critical information and cannot be replaced by another test.
Will my child receive a “kid-sized” radiation dose?
With imaging tests such as CT, there are methods available to tailor the examination to account for the differences in size and shape in children and ensure that only the necessary amount of radiation is used for your child’s exam. These have been specifically addressed at our institution. At UCSF Benioff Children’s Hospital we are very skilled at using new technologies which deliver very low dose examinations and we believe we are a leading Medical Center for performing imaging tests with the lowest dose possible. For example, some of our CT examinations are just about equivalent to a 2 view chest x-ray, and we maximize the use of pulsed fluoroscopy which drastically lowers the amount of radiation needed to produced high quality imaging tests.
Have the facility and radiology professionals done all they can to lower radiation dose as much as possible to answer their doctor’s question?
Examinations should be regularly monitored to ensure proper implementation of all radiation dose-sparing protocols as part of a quality assurance program. Areas for potential further dose reduction or image quality improvement should be identified. At UCSF Benioff Children’s hospital we conduct routine monitoring of all CT scans performed with regular meetings of the Radiation Oversight Committee.
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