4 out of 5 hospitals report pediatric head CT dosage in line with recommendations

Most U.S. hospitals report radiation doses in line with accreditation limits issued by the American College of Radiology (ACR) for children undergoing head CT scans, according to the results of a survey published in the March issue of the American Journal of Roentgenology.

The head is the most-scanned body part for pediatric patients, with CT scans performed most often in cases of trauma that require timely assessment, diagnosis and treatment. “CT is used to diagnose and manage traumatic brain injury in children because it is readily available, fast, and sensitive in identifying injuries that require immediate intervention in an acute care setting,” according to lead author Kalpana M. Kanal, PhD, DABR, of the University of Washington in Seattle, and colleagues.

But this increased use comes at a cost to patient safety—The National Council on Radiation Protection estimates that 85 million CT scans were performed in 2011, 5-11 percent of which were performed on children, making CT the single biggest source of medical radiation exposure in the country.

Kanal and her team set out to assess and compare variations in radiation dosage for pediatric head CT scans in U.S. hospitals. They used survey responses from 253 hospitals from around the nation to compile data on protocols for pediatric head examination, CT dose index volume, dose-length product and scanner type.

Their results showed that 82 percent of the nation’s hospitals report radiation doses at or below guidelines set by the ACR, with the national mean CT dose index volume estimated at 27 mGy, well below the ACR accreditation limit of 40 mGy.

Children’s hospitals reported even lower doses, reporting a mean of just 7 mGy, 18 percent lower than the nation’s general hospitals. “This finding suggests that children’s hospitals may have a higher level of awareness of tailored CT protocols for pediatric populations,” wrote Kanal and colleagues.

Also of note was the almost universal use of MDCT scanners (99.3 percent), with newer scanners aiding in dose reduction through tube modulation and advanced options in iterative reconstruction technology.

Kanal and her team plan to continue their investigation into dosage variations for pediatric CT in U.S. hospitals using post-scan dose estimates from ACR’s Dose Index Registry.