Radiation Risk to Children From Computed Tomography

Imaging studies that use ionizing radiation are an essential tool for the evaluation of many disorders of childhood. Ionizing radiation is used in radiography, fluoroscopy, angiography, and computed tomography scanning. Computed tomography is of particular interest because of its relatively high radiation dose and wide use. Consensus statements on radiation risk suggest that it is reasonable to act on the assumption that low-level radiation may have a small risk of causing cancer. The medical community should seek ways to decrease radiation exposure by using radiation doses as low as reasonably achievable and by performing these studies only when necessary. There is wide agreement that the benefits of an indicated computed tomography scan far outweigh the risks. Pediatric health care professionals’ roles in the use of computed tomography on children include deciding when a computed tomography scan is necessary and discussing the risk with patients and families. Radiologists should be a source of consultation when forming imaging strategies and should create specific protocols with scanning techniques optimized for pediatric patients. Families and patients should be encouraged to ask questions about the risks and benefits of computed tomography scanning. The information in this report is provided to aid in decision-making and discussions with the health care team, patients, and families. INTRODUCTION Computed tomography (CT) is a valuable and essential addition to the array of imaging modalities for children. CT uses x-rays to provide rapid, consistent, and detailed information about virtually any organ system in infants and children. Because x-rays are an integral component for image formation with CT, there is an obligatory radiation exposure during the CT examination. Ionizing radiation has been demonstrated to increase the risk of cancer in individuals exposed to high doses of radiation. Moreover, recent reports have discussed the potential risk of cancer that results from the lower radiation exposure from CT examinations. These publications have raised concerns on the part of pediatricians, patients, and families. A review of this literature, however, shows widely differing opinions concerning the cancer risk of diagnostic imaging studies. Although many different statements on ionizing-radiation risk exist in the literature, one principle has been supported consistently by the authors of articles to which this report refers: any estimated risk of a CT scan is far less than the likely benefit to the patient for indicated examinations. This clinical report is intended to serve as a resource for pediatric health care www.pediatrics.org/cgi/doi/10.1542/ peds.2007-1910 doi:10.1542/peds.2007-1910 All clinical reports from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time. The recommendations in this report do not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.