Breast Biopsy 
Increasing Popularity of CT Scans May Be Cause for Alarm, Especially in Pediatric Patients
Press Release, November 9, 2006
The use of CT-scans to diagnose and screen for medical conditions have become common place. In fact, from 2000-2003 CT scanning has risen nearly 50 percent. Usage of the technology has climbed for a variety of reasons, including the ability to provide detailed, crisp images; minimal cost to an insured patient; the non-invasive nature of the test; and the popularity of full body scans for check-ups. Despite the many benefits of the technology, there is a downside -- radiation exposure. So, is this cause for concern?
Dr. David Solsberg, radiologist with Invision/Radiology Imaging Associates (RIA) says, “Imaging has revolutionized the diagnosis and treatment of many disorders. But as with any test the benefits must be carefully weighed against potential risks. Radiation exposure has been implicated in a slight increase in the risk of cancer. For the general public, radiation exposure from a CT-scan is minimal and in the vast majority of cases the benefit of diagnosis clearly outweighs the risk. However alternative diagnostic techniques that do not expose the patient to radiation such as ultrasound and MRI should be used whenever possible. In those patients that must undergo scanning low dose techniques are used to minimize exposure. Also the newer multiple slice CT technologies have dramatically reduced exposure.“
Children may be more sensitive than adults to radiation. They have a longer life expectancy, which provides more time to show radiation damage and growing cells may be more sensitive to radiation damage. With regard to adults, certain areas of the body – especially the chest and abdomen-- may require a higher dose to obtain clearer images. So, Invision’s radiologists employ ALARA (as low as reasonably allowable) guidelines limit exposure. Specific techniques are used to adjust the dose according to the organ system being imaged and the size of the patients. For example, in children Invision uses only a fraction of the dose compared to that used for a larger adult. Additionally, the Invision staff and doctors take the time to educate patients about the risks and benefits of the technology.
In an effort to help patients or parents of children undergoing CT-scans make informed decisions, Dr. Solsberg suggests asking the following questions prior to the procedure:
- What type of test is being recommended?
- Is CT the best examination to diagnose conditions in my child or me?
- What are the pros and cons of the test?
- Is there an alternative (ultrasound, or MRI, which do not use ionizing radiation) available that will provide comparable images without or with less radiation exposure?
- How will you ensure that you are limiting my/my child’s exposure to radiation?
- In order to lessen the exposure, do you adjust for size, weight, area being scanned?
- Will a radiologist be responsible for performing and interpreting the exam and is equipment certified and up to date?
“When it comes to CT, one size does not fit all. In fact, the size of the patient undergoing the scan has a bearing on the amount of radiation necessary to penetrate the body and get an image. Radiologists are able to - and should - adjust settings to give the lowest possible dose of radiation,” says Dr. Solsberg. In addition to making adjustments to the contrast and tailoring the settings to the patient, the radiologist may recommend an alternative test that can provide comparable images without compromising diagnostic ability.
As the popularity of CT-scans continues to rise, concerns regarding the risks associated with the technology will also increase. Even though no studies have directly examined whether people who have had multiple CT-scans went on to develop cancer – why risk it? In the meantime, Dr. Solsberg suggests that patients undergoing CT-scans ask themselves and their doctors “how much is too much and is the test necessary?”
For more information on CT-scans, diagnostic tests, non-surgical alternatives to surgery, as well as information on Invision/Radiology Imaging Associates, visit www.riainvision.com
Additional informaton on the health risks of ionizing radiation can be found in the Beir VII report.
