Failure to Adjust CT Scanners to Pediatric Settings is a Major Cause of Unnecessary Radiation Exposure to Children

Author(s): Jianna J. Lin*, Jeremy Zhang, Lucille Anzia, Laura L. Hayes

CT scans are an indispensable tool for evaluating head injuries and neurological symptoms, yet they are the leading contributor to medical radiation exposure in the United States. High levels of such exposure pose significant health risks for children, whose developing bodies are less resilient to radiation injury. Here we review mean radiation dose (Total Exam DLP) and CTDlvol from head CT scans of 149 cases to assess for factors thought to be potential contributors to excess radiation exposure. Such factors included scan indication (trauma, shunts, other head complaints), number of repeat scans, and the type of facility the scan was performed (adult vs. pediatric). Analyses revealed that among scans performed to evaluate head trauma or routine indications (e.g. headache, vomiting focal neurologic deficits), the mean radiation dose a administered was significantly higher in adults hospitals when compared to pediatric hospitals. Findings highlight the importance of ensuring appropriate dose settings to increase the safety of CT scans for children. Based on our results identifying suboptimal scanner settings as a fundamental cause of excess radiation exposure, the evidence supports adjusting protocols to appropriate settings as the most effective method of reducing excess radiation exposure to children receiving head CT scans.