Diagnostic Imaging


Minimizing radiation dose in paediatrics

CT is one of the most powerful diagnostic tools in medicine today. The benefits it brings to a large number of patients are unquestioned. However, as with all medical interventions, there are potential risks in addition to its benefits. The cancer risks associated with X-rays have long been known, and children are more sensitive to the effects of ionizing radiation than adults. Given the doses associated with CT it is essential that this powerful modality be used appropriately.  Every effort should be made to reduce radiation dose as much as possible while maintaining diagnostic quality. This is in accordance with the ALARA (As Low As Reasonably Achievable) principle of radiation safety.


Eliminate inappropriate referrals for CT

A radiologist prior to booking should review all requests for CT examinations. The ‘gatekeeping’ role of the radiologist is an important element in radiation safety. Discussion between referring physician and radiologist of the expected yield of CT and impact on clinical management should be encouraged as a routine part of optimal patient care. Use of alternative modalities not involving ionizing radiation – ultrasound and MR – should be considered wherever possible. The smaller body habitus of children allows ultrasound to have a wider range of application than in adults. MR offers a valuable modality for many (although not all) clinical indications currently served by CT, and greater access to paediatric MR is an ongoing need. In some cases, plain radiography may provide the information desired, with significantly lower radiation dose.
If regular follow-up imaging is required, then alternative modalities should be strongly considered if appropriate and available. If CT is required, then the timing between scans should not be unduly short, and consideration should be given to reducing dose below initial levels.

Optimize CT protocol

The CT protocol appropriate to each patient will depend on clinical indication, patient age and weight. Details of the patients past history and reasons for the current examination should be provided on the request form to enable selection of an appropriate protocol.

Body CT

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Head CT

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