Features | Partner Sites | Information | LinkXpress
Sign In
Ampronix
Schiller
GLOBETECH PUBLISHING LLC

CT Scans in Children with Headaches Used Widely in and out of Emergency Department

By Medimaging International staff writers
Posted on 19 Aug 2013
Sixty-seven percent of children in the United States received their computed tomography (CT) scans outside of the emergency department (ED) setting.

In the United States, more than 25% of the children treated for headache across a range of care settings received a CT imaging scan, possibly exposing them to unnecessary radiation and increased cancer risks, according to new research.

The study’s findings were published in the July 2013 issue of the journal Pediatrics. That providers sometimes use CT scans to rule out brain tumors or brain abnormalities because parents are concerned about this possibility—which is the cause of less than 1% of those with pediatric headache—when overuse of CT scans can increase the risk of brain tumors,” said coauthor Dr. Paul Young, professor of pediatrics at the University of Utah School of Medicine (Salt Lake City, USA) who was one of the individuals designated by the American Academy of Pediatrics (Elk Grove Village, IL, USA to participate in the research. “It’s possible that physicians underestimate the risks associated with CT scans.”

The use of CT scans to diagnose pediatric headache remains high despite increased cancer risks and the fact that except for certain narrow indications, providers often gain little clinically useful information from these imaging studies while exposing children to unnecessary radiation. Headaches are among the five most typical health problems in children, as well as one of the most frequent reasons for pediatric neuroimaging, especially in EDs.

The Pediatrics study found that children who were evaluated in the emergency room were four times more likely to have CT scans than those children who did not go to the emergency room. However, even outside the emergency room, use of CT scans remained widespread. In pediatric patients getting CT scans for headaches, 67% received their scans outside of the emergency department setting.

Other researchers have gathered evidence that CT scans increase a child’s lifetime risk of cancer. A retrospective study published in the Lancet in 2012 suggested that the cumulative radiation from as few as 2 to 3 CT scans in a child younger than 15 years old could triple the risk of brain tumors, while 5 to 10 head scans could triple the risk of leukemia. A study published in the June 2013 edition of JAMA Pediatrics noted that a radiation-induced solid tumor is predicted to result from every 300 to 390 abdomen/pelvis scans in girls.

The Pediatrics study, written by authors either employed by or designated by HealthCore (Wilmington, DE, USA), American Academy of Pediatrics (AAP; Elk Grove Village, IL, USA), American Academy of Family Physicians (AAFP; Leawood, KS, USA), American Academy of Neurology (AAN; Minneapolis, MN, USA), and WellPoint, stemmed from discussions by WellPoint and AAP to find out “to what extent do current practice patterns for treatment of pediatric headache align with practice guidelines?”

An advisory group including representatives from the AAP, AAN, and AAFP helped frame the discussion that resulted in this study. The AAN recommends in favor of MRI scans as opposed to CT imaging for individuals with headache, a normal history, and neurologic examination. This recommendation was endorsed by the American Academy of Pediatrics and the American Colleges of Radiology (Reston, VA, USA).

“We found that AAN imaging guidelines were most often followed by neurologists when treating children, but not by other physicians,” said Dr. Alan Rosenberg, WellPoint vice president of medical and clinical pharmacy policy. “We want to better understand current utilization patterns to help parents of patients, clinicians, and health benefits companies with the information we need to inform and facilitate change to improve care for children and adolescents.”

In 2008, 1.7 million pediatric CT scans were performed in the ED, 6% of all pediatric emergency room visits that year. As many as 28% of those scans were performed for headache unrelated to head injury. Quality improvement initiatives, such as those supported by AAN and advocated in the Choosing Wisely Campaign by the AAP, could significantly reduce pediatric and adolescent exposure to unnecessary radiation.

The retrospective analysis included 15,836 children aged three to 12 years old with more than two medical claims for headache.

Related Links:

University of Utah School of Medicine
American Academy of Pediatrics
HealthCore



Channels

MRI

view channel
Image: Using an MRI technique that is sensitive to certain byproducts of cell metabolism, including levels of glucose and acidity, University of Iowa researchers discovered previously unrecognized differences in the brains of patients with bipolar disorder. The T1rho MRI scans showed brain regions of elevated signal in the 15 participants with bipolar disorder compared to the 25 participants who did not have bipolar disorder. The primary regions of difference are the cerebral white matter (yellow) and the cerebellum (red) (Photo courtesy of the University of Iowa).

Quantitative, High-Resolution T1 Rho MRI Mapping Scan Reveals Brain Differences in Bipolar Disorder

Using a different sort of magnetic resonance imaging (MRI) technology, researchers have discovered previously unrecognized differences in the brains of patients with bipolar disorder. In particular, the... Read more

Ultrasound

view channel

Guidelines Released for Quantitative Monitoring of Critically Ill and Surgery Patients Using Echocardiography

The American Society of Echocardiography (ASE; Morrisville, NC, USA) has published clinical guidelines describing how and when echocardiography can be used for medical and surgical therapy in adult patients. The guidelines were published in the January 2015 issue of the American Society of Echocardiography.... Read more

Nuclear medicine

view channel
Image: Created by averaging PET scan data from chronic pain patients (left) and healthy controls (right), the images reveal higher levels of inflammation-associated translocator protein (orange/red) in the thalamus and other brain regions of chronic pain patients (Photo courtesy of Marco Loggia, Martinos Center for Biomedical Imaging, Massachusetts General Hospital).

PET/MR Imaging Shows First Evidence of Neuroinflammation in Chronic Pain Patients’ Brains

For the first time, researchers have used neuroimaging strategies to find evidence of neuroinflammation in major regions of the brains of patients with chronic pain. By showing that levels of an i... Read more

General/Advanced Imaging

view channel
Image: Dr. Miles was part of the team that helped identify facial measurements in children with autism that may lead to a screening tool for young children and provide clues to its genetic causes (Photo courtesy of Rebecca F. Miller).

Advanced 3D Facial Imaging Designed to Help in Early Identification of Autism

Autism is a range of closely related disorders observed in patients who exhibit a shared assortment of symptoms, including delays in learning to communicate and interrelate socially. Early detection of... Read more

Imaging IT

view channel

Findings Reveal Health Information Exchange Decreases Repeat Imaging

The use of health information exchange (HIE) systems to share reports on imaging tests, such as X-rays and magnetic resonance imaging (MRI) scans, can help reduce the number of times patients undergo the precisely same test. A new study suggests that HIE technology that gives healthcare providers immediate, electronic access... Read more

Industry News

view channel
Image: 3-D Image of the Mindray DC-70 Ultrsound System (Photo courtesy of Mindray).

Ultrasound Equipment Sector in United States Expected to Grow Through 2020

Ultrasound equipment market in the United States is expected to remain stable and continue to grow, exceeding USD 2 billion by 2020 as revealed in a report by iData Research (Burnaby, BC, Canada).... Read more
 

Events

01 Feb 2015 - 06 Feb 2015
02 Feb 2015 - 06 Feb 2015
Copyright © 2000-2015 Globetech Media. All rights reserved.