While only individual medical providers make the Image Gently pledge, hospitals and other facilities accredited for pediatric CT by the American College of Radiology must show they follow the protocols backed by the campaign. Such facilities commit to imaging children with appropriate, child-size doses of radiation. According to the alliance, such hospitals in the Washington area include, among others, Children’s, MedStar Georgetown University, some Inova facilities in Virginia, Shady Grove Adventist Hospital, Sibley Memorial and Suburban (through a joint venture with a doctor group).
In early May, the Food and Drug Administration introduced a proposal aimed at reducing unnecessary radiation exposure for children. It recommends that manufacturers design new X-ray imaging devices, including CT scans, with instructions and protocols concerning use in children. Companies that can’t demonstrate that their devices are safe and effective for children would be asked to include a label cautioning against use in children.
The agency is seeking public comment on the proposal, and plans a workshop in July that will include manufacturers, device users and patient advocates.
The FDA is also collaborating with the radiation safety alliance and device manufacturers to come up with safety training materials for scanning children with existing equipment. And the agency has launched a Web site
with information on the risks and benefits of imaging.
Doctors suggest that parents help keep their children safe by talking to their children’s doctors about CTs, being advocates for their children and asking if an imaging facility takes steps to reduce radiation in children. Doctors said parents also should be careful not to push for CT scans when another test, such as an MRI, regular X-ray or in some cases ultrasound might be just as good.
Frush reiterated that CTs are sometimes the best course of action, especially when a child’s condition is serious or difficult to diagnose. Sze agreed, and said that a growing number of doctors are becoming more skilled in knowing when and how to use CT on children.
A study published online in February in the journal Pediatrics looked at two pediatric emergency departments and found no overall increase in CT use between 2003 and 2010, and a decrease in certain areas of the body where non-radiation-based tests were available. This “may correlate with increased awareness of radiation risk in children,” concluded the researchers.
As for Doran, she brought Isabel in for another CT scan in mid-May — the last one she’ll need for a while.
“I’m pretty happy about that,” she said. “I’m glad that we’re getting to the end of it.”
Ungar is a medical writer at the Courier-Journal in Louisville.