Justification of clinical indication is the most important facet of reducing radiation dose with CT scanning. A considerable number of pediatric CT scans lack appropriate justification or can be replaced with other imaging methods with lower or no ionizing radiation, such as radiography, ultrasonography, and magnetic resonance imaging (MRI), which can provide similar diagnostic data for some clinical conditions.

“When not clinically indicated, not performing a CT examination is certainly the best radiation dose reduction strategy. However, when a CT scan is indicated, there are steps that can be taken to optimize the dose that children receive. It’s important that all imaging providers take these steps as indicated,” said Mannudeep K. Kalra, MD, from Massachusetts General Hospital (MGH; Boston, MA, USA), and Harvard Medical School (Boston, MA, USA), and an author of the article.

Investigators from MGH, Harvard Medical School, in Boston, MA, and Johns Hopkins University (JHU; Baltimore, MD, USA) reviewed practical approaches for reducing radiation dose associated with pediatric CT scanning. The study’s findings were published in the January 2012 issue of the Journal of the American College of Radiology.

“Radiation dose reduction in children starts with the optimization of pediatric CT protocols. CT protocols should be strictly optimized on the basis of body size, body region, clinical indication and the availability of prior imaging,” said Mahadevappa Mahesh, MS, PhD, from JHU, another author of the article.

Further steps include using a lower tube current (and voltage), limiting the scan length to include only the region of interest, and using new techniques of image postprocessing and reconstruction. “Children are more sensitive to radiation-induced risks and need special attention. Therefore, while designing CT protocols, it is crucial to keep clinical indications, weight and prior available imaging in mind to optimize radiation dose,” concluded Dr. Mahesh.

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