When it comes to kids and radiology: "Image gently"
By James Donaldson, MD
A lot of people think radiologists are the technologists who take the images when they have diagnostic tests like X-rays, CT scans and MRIs. They don’t realize there’s a physician behind the scenes who generally makes the diagnosis of the patient for their doctor. That’s why radiologists are sometimes referred to as the “doctor’s doctor.”
So as the doctors’ doctors, we pediatric radiologists are leading the charge in changing radiology practices and educating community physicians who refer patients to us so that together we all reduce doses of radiation in kids.
Radiation is valuable and when used properly can save a lot of lives. But many CT scanners in adult hospitals are calibrated for adults, not children. Because of that, children can get huge doses of extra radiation if the standard equipment settings are not properly adjusted to a child’s size. Less is better, so "image gently." Kids have a lifetime to live and their tissues are more susceptible to radiation.
The radiologists at Children’s Memorial feel passionately about this topic. That’s why over the years we have reduced the doses of radiation of our CT scans (in which adult-specific radiation can be equal to 300 chest x-rays), image only the specific areas we need to and use the technology only when nothing else will do.
For example, we can often use MRI in place of CT scans and find that they are just as effective in getting the pictures we need to make a diagnosis. Likewise, we can often substitute ultrasound instead of CT scans in the Emergency Room.
To increase awareness of the need to reduce radiation in children, we’re part of The Alliance for Radiation Safety in Pediatric Imaging’s “Image Gently” campaign, a campaign started by pediatric radiologists who have recognized the potential dangers for years.
Pediatric radiology is a challenging field in many respects. For one thing, we’re working with smaller anatomy, so our imaging equipment has to have higher resolution. With children we’re often dealing with different diseases than in adults, and the pediatric radiologist needs to understand these differences.
Our particular expertise in child-focused radiology is something that differentiates us from many surrounding community hospitals. And by sharing that expertise, we think that’s good for everybody.
James Donaldson, MD, is chairman of the Department of Medical Imaging and is the Earl J. Frederick Professor of Radiology.