Children’s hospitals utilizing less CT in favor of other modalities

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CT utilization in children’s hospitals is declining, possibly due to potential side effects related to pediatric exposure to ionizing radiation, according to a new study published in Pediatrics.

Michelle W. Parker, MD, of the division of hospital medicine at Cincinnati Children’s Hospital Medical Center, and colleagues tracked CT utilization from 2004 to 2012 with data from 33 children’s hospitals.

According to the authors, more and more research has revealed the possibility that exposing children to ionizing radiation may increase their risk of cancer, leading to efforts to minimize such exposure.

“Multiple strategies have been pursued to minimize radiation dosage to children, such as reduction of dosage administered per study, reduction of number of CT phases, and reduced frequency of CT utilization,” the authors wrote.

Going by the data, those efforts seem to have been effective. In fact, each of the 10 common childhood diagnoses this study focused on saw a reduction in CT utilization from 2004 to 2012.

The odds of a patient receiving CT for an appendectomy in 2012, for example, were 40 percent less than the odds of that same patient receiving CT in 2004.

Meanwhile, MRI and ultrasound utilization showed a noticeable increase in 8 of the 10 childhood diagnoses, showing that physicians are turning to other modalities instead of CT.

The authors did note that there may be additional reasons for this shift to other modalities other than physicians purposefully moving away from CT.  

“Contributory factors supporting this shift may include advances in diagnostic imaging quality for nonradiation modalities and increased availability of staff needed to perform the studies, such as sedation teams, which may be needed for MRI,” the authors wrote.

The authors also wrote that they see the decrease in CT as multifactorial. The Alliance for Radiation Safety, for example, was formed in 2006 and raised awareness about the potential harms of radiation exposure and the need for lower doses of CT to be used when treating children.

And the evolution of technology since 2004 could have played a crucial role in this shift. The authors list the implementation of electronic health records and health information exchanges as two specific ways technology has changed in recent years, saying both advances could theoretically be responsible for better-informed physicians making smarter decisions that involve utilizing less CT than they may have in the past.