Paediatric computed tomography radiation dose: A review of the global dilemma

Abstract

Computed tomography (CT) has earned a well-deserved role in diagnostic radiology, producing cross-sectional and three-dimensional images which permit enhanced diagnosis of many pathogenic processes. The speed, versatility, accuracy, and non-invasiveness of this procedure have resulted in a rapid increase in its use. CT imaging, however, delivers a substantially higher radiation dose than alternative imaging methodologies, particularly in children due to their smaller body dimensions. In addition, CT use in children produces an increased lifetime risk of cancer, as children's developing organs and tissues are inherently more vulnerable to cellular damage than those of adults. Though individual risks are small, the increasing use of CT scans in children make this an important public health problem. Various organizations have recommended measures to minimize unnecessary exposures to radiation through CT scanning. These include elimination of multiple or medically unnecessary scans, development of patient-specific dosing guidelines, and use of alternative radiographic methodology wherever possible. Another important factor in excessive CT exposures, however, is a documented lack of awareness among medical practitioners of the doses involved in CT usage as well as its significant potential dangers. This review examines the effects of paediatric CT radiation, discusses the level of medical practitioner awareness of these effects, and offers recommendations on alternative diagnostic methods and practitioner education.