Research published in the June 7, 2012, issue of the Lancet suggests a possible increased risk of brain cancer and leukemia among patients who received computed tomography scans of the head while they were children. For many parents, this article caused alarm and concern.
The American Society of Radiologic Technologists reminds parents that CT scans are an important medical tool that can provide information critical to the diagnosis and treatment of a child's condition.
"There is no question that CT scans save lives," said ASRT President Dawn McNeil, M.S.M., R.T.(R)(M), RDMS, RVT, CRA. "More than 70 million CT scans are performed each year in the United States, and about 7 million of those exams are on performed on children. In the vast majority of these cases, the benefits gained through the medical information obtained far outweigh the small risks involved. But because CT exams involve radiation, they must be performed only by qualified individuals who are properly educated to minimize dose in every possible way."
The best way to ensure that computed tomography scans deliver the lowest possible dose is by establishing standards for the personnel who perform them, said Ms. McNeil. "Radiologic technologists who are certified in CT know how to make the proper adjustments to reduce the total dose delivered to the patient."
The ASRT, which represents more than 146,000 radiologic technologists, is committed to ensuring radiation dose is as low as possible for all types of medical imaging examinations. To reduce dose delivered during CT scans, the ASRT recommends:
- Technologists responsible for performing CT scans should be certified in computed tomography by the American Registry of Radiologic Technologists. To become certified, technologists must meet specific clinical requirements and pass a national test covering subjects such as patient assessment, radiation safety, CT systems and image processing, as well as knowledge of specific imaging procedures. They also must complete continuing education to remain registered. "One of the best ways to minimize dose is to ensure that only qualified personnel perform CT scans," said Ms. McNeil.
- Educational and certification requirements for personnel who perform medical imaging examinations should be standardized nationwide. Currently, there is wide variation from state to state in the requirements for personnel who perform these examinations. The Consistency, Accuracy, Responsibility and Excellence in Medical Imaging and Radiation Therapy bill (CARE bill), would establish minimum national standards. The ASRT has lobbied for passage of the CARE bill for more than 12 years as an important way to ensure the safety of patients undergoing medical imaging examinations.
- Facilities that perform CT should participate in a CT accreditation program such as the ones offered by the American College of Radiology and the Intersocietal Commission for the Accreditation of Computed Tomography Laboratories. These programs evaluate qualifications of personnel, equipment performance, effectiveness of quality control measures and quality of CT images. In addition, the ICACTL accreditation program specifically requires personnel certification in CT, which ASRT supports.
- CT scans should be performed only when there is a clear medical reason. CT scans are a valuable diagnostic tool and often are the only method of obtaining important diagnostic information, but they should be used only when medically necessary.
- Institutions should establish protocols to reduce and standardize CT dose. For example, multiphase scans should not be routinely ordered or performed, dose should be adjusted based on the patient's size and weight, and only the indicated area should be scanned. The Image Gently campaign, which focuses on reducing dose to children undergoing CT and other types of medical imaging examinations, offers sample CT protocols at its website at www.imagegently.org. The ASRT is a founding member of the Image Gently campaign, and worked with content experts to design educational modules for technologists related to decreasing pediatric exposure in CT. These modules are currently available on the Image Gently Web site.
- Clinicians should consider alternatives to CT when possible. CT scans are often the best way to diagnose a child's condition. In some cases, however, the diagnosis may be obtained by using other types of imaging exams, such as ultrasound or magnetic resonance imaging, that do not expose a child to ionizing radiation.