"That these are children with cancer does not negate the fact that they need to be handled with care. In fact, it increases the need for oversight by the pediatric radiologist." -- Sara J. Abramson, Co-Director of Pediatric Radiology at Memorial Sloan-Kettering |
Sara J. Abramson, Director of Pediatric Radiology at Memorial Sloan-Kettering and a member of the Image Gently project, points out that the lifetime accumulated effects of radiation may be a concern, especially for children who have been treated for cancer. As a result, she notes, the pediatric radiologists at Memorial Sloan-Kettering must approve every CT scan before it is performed on a child. "That these are children with cancer does not negate the fact that they need to be handled with care," she says. "In fact, it increases the need for oversight by the pediatric radiologist."
For more than ten years, radiologists and technicians at Memorial Sloan-Kettering have followed the ALARA (As Low As Reasonably Achievable) standard operating principle, using equipment and software that lower the radiation exposure in children by setting the radiation parameters based on the size of the child.
Increased Risk?
A recent and much-debated study in the New England Journal of Medicine [PubMed Abstract] suggests that more frequent use of CT scanning may increase a person's lifetime risk of developing cancer. However, experts note that this risk may be outweighed by a CT scan's ability to diagnose an illness that potentially could be missed by other imaging tools. The Image Gently project states that, like any medical test, the beneficial information gained from the test should outweigh the risks generated by having the test performed.
"We believe this project can help decrease unnecessary imaging and also unnecessary radiation exposure in the pediatric population," says Dr. Abramson, "not only by giving specific parameters for the actual imaging but also by providing guidelines for determining what constitutes necessary imaging. This will help radiologists in academic centers, private practices, and local hospitals. It is also meant to inform emergency room physicians and pediatricians about the need to think before ordering CT for children -- and to image 'gently' when they do."
Recommendations
The project's members recommend that parents ask if an imaging facility has American College of Radiology (ACR) accreditation. The Memorial Sloan-Kettering Cancer Center radiology department is ACR accredited. The Image Gently project also provides medical professionals with specific parameters and suggested techniques that can be used to dramatically decrease the amount of radiation children are exposed to during CT.
