As CT scans become more common for children, concerns about radiation grow

Isabel Doran is only 4 years old, but she’s already had about 15 CT scans — and every one comes with a dose of radiation.

“I think there’s always that part of you that thinks it’s too much,” said her mother, Veronica Doran of Burke.

(Dayna Smith/TWP) - With her mother, Veronica Doran, beside her, Isabel sheds a tear while being prepped for a CT scan.

More health and science news

Likely health-plan rates in Calif. under new law lower than expected

Sandhya Somashekhar

The published prices partly rebut warnings by critics that many people will experience ‘rate shock.’

Two infants among tornado dead

Debbi Wilgoren

Ten fatally injured children include a pair of sisters, and 4-month-old whose mother also was killed.

Green groups criticize Environmental Defense Fund

Lenny Bernstein

Large pro-environment group is scolded for joining forces with oil companies on “fracking.”

Doran is glad the scans have allowed doctors at Children’s National Medical Center to monitor Isabel’s progress while they treat her for a kidney cancer called Wilms’ tumor. But she’s worried about the long-term effects of the scans, which could put Isabel at risk for another cancer down the road.

Although the risk is relatively small, many parents and doctors are raising such concerns as the use of CT scanning has surged among the young. About 7 million of the scans are performed annually in children in the United States, a figure that has been rising 10 percent a year, according to the Alliance for Radiation Safety in Pediatric Imaging, a consortium of medical organizations.

A study published online in April in the journal Radiology found that in almost 17 million emergency room visits by children from 1999 to 2007, the odds of a child’s receiving a CT scan rose every year. Those findings bolster research published in the same journal last year, which found that the number of ER visits nationally in which children were given CT scans rose fivefold between 1995 and 2008 — from 330,000 annually to 1.65 million.

Many children get more than one scan. According to the National Cancer Institute, about a third who have undergone CT scans have had at least three.

“There have been significant increases. What we’ve seen in adults has been mirrored in kids,” said Donald Frush, chairman of the American College of Radiology’s pediatric radiology commission. “We do much more by CT.”

Frush and other doctors said there’s a good reason for that: The scans produce detailed images that can help them diagnose and monitor problems.

“CT is a very, very helpful tool,” Frush said. “It is lifesaving.”

But sometimes, doctors said, it is overused as parents push for an extra measure of assurance that a child is all right and as physicians try to guard against getting sued. “Defensive medicine is very prevalent and does drive what people do,” Frush said.

Many medical providers have pledged to reduce unnecessary CTs, with 15,798 signing on to an alliance campaign developed five years ago called Image Gently. That campaign promotes performing scans only when the medical benefit is clear. A recent study suggests the number of CTs performed in children may be starting to drop in some places.

“It is helping,” Frush said. “We honestly are doing things better. We’re questioning things more.”

‘You sort of go on faith’

CT, short for computed tomography, uses X-rays generated from a machine rotated around the body to create three-dimensional pictures. It’s used to investigate such problems as lymphoma, neuroblastoma, kidney tumors, congential heart malformations, head injuries and abdominal pain.

Images produced by the scans are more detailed than regular X-rays, and they’re better at revealing bone fractures than magnetic resonance imaging scans, which don’t use radiation and show more detail when looking at soft tissue. CTs are also relatively quick, typically requiring around 15 minutes, and patients don’t have to hold still for long periods, as they do with MRIs.