Questions About CT Scans in Children?
Jun 13, 2012 - 7:35:19 PM
Ask a Radiologist Board Certified by the American Board of Radiology for Help.
(HealthNewsDigest.com) - The recent publication of a scientific study reporting the potential risk of brain cancer and leukemia from CT scans in children1 was also reported in the popular press. As a result, parents and other caregivers may have questions about CT scans or may be afraid to allow their children to undergo a CT scan, even though the benefit of the test far outweighs its risks. The American Board of Radiology (ABR) and the American Board of Radiology Foundation (ABRF) agree with statements made by the American College of Radiology, the Radiological Society of North America, the Society for Pediatric Radiology, and the American Association of Physicists in Medicine regarding the importance of weighing the benefits of a CT examination against any potential risk.
“In recent years, there has been a major effort to reduce doses from pediatric CT scanning,” said G. Donald Frey, PhD, professor of radiology at the Medical University of South Carolina and ABR associate executive director for medical physics. “This study points out that even using the higher doses that were common before pediatric dose reduction techniques became widespread, the probability of not getting leukemia from a head CT scan was 99.99 percent.”
ABR Trustee Donald Frush, MD, chief of the Division of Pediatric Radiology, Duke University School of Medicine, asserted that CT scans are clearly indicated in certain situations. These include major motor vehicle accidents where there could be multiple potential organ injuries or abdominal pain where surgery might be needed for a bowel obstruction or appendicitis.
“Just hearing the downsides of driving a car, crossing a street, or flying in an airplane, you’ve only discussed the risks of all of these things,” said Dr. Frush in an interview on National Public Radio. “No one would drive a car, or walk across a street, or fly in an airplane if they were only familiar with the risks.”
Although the use of CT scans increased during the past decade, it has now stabilized. CT scans have saved countless lives, and the radiology community continues to take steps to ensure that the technology is used appropriately.
"The balance of bringing tremendous benefit with small risk to the patient is a constant focus of all who are working within the community of medical imaging,” said Glenn S. Forbes, MD, professor emeritus of radiology for Mayo Medical School, Rochester, Minnesota, and chairman of the Board of the ABR Foundation (ABRF).
“With a sole commitment to serving the public good, this summer the ABRF will convene the first of a series of national summits that will aim to identify and address—in coordinated fashion—the safety opportunities in our current system of medical imaging,” Dr. Forbes continued. “Invitees include patient safety and consumer groups, quality and standards organizations, payers, regulators, manufacturers, healthcare providers, national awareness and education campaigns, healthcare delivery organizations, and accrediting and certifying bodies to form a public/private/professional partnership.”
The ABR and ABRF also join the Alliance for Radiation Safety in Pediatric Imaging in urging parents to ask questions about CT scans and to work together with their children’s doctors. One question recommended by the Alliance is whether or not the doctor reading the CT scan is certified by the American Board of Radiology.
“All ABR-certified radiologists and medical physicists are tested, as part of their certification process, to ensure that they have the skills to perform pediatric CT of the highest quality with the least radiation dose,” said ABR Executive Director Gary J. Becker, MD. “They can also help parents decide if an exam is appropriate and answer any questions about quality, safety, or dose.”
In addition, the ABR and ABRF recommend that parents check to see if the facility where the scan will be performed has an ABR board-certified medical physicist available to ensure proper calibration and safety of scanning equipment.
Board certification by one of the 24 American Board of Medical Specialties (ABMS) Member Boards, including the ABR, is widely recognized as the highest health care industry standard for assessment of a physician’s knowledge, experience, and skills. Board-certified physicians have participated in a voluntary process that involves far more than what’s required for them to become licensed.
For example, after earning a college degree and undergoing a demanding acceptance process, a physician spends four years in medical school and then passes a three-step exam to gain medical license. However, that is only the beginning for a board-certified radiologist, who also completes a one-year clinical internship and four years of residency, passes rigorous ABR qualifying examinations, provides letters of attestation from the program director and/or faculty, and finally, passes an extensive oral exam with 10 different examiners. ABR board-certified medical physicists also must meet stringent requirements above and beyond their education, which include passing an extensive three-part examination. Training for all radiologists includes radiation biology, radiation physics, and radiation safety.
The ABMS maintains a database of nearly 800,000 physicians, including radiologists and medical physicists. Parents can find out for free if a physician is board certified by the ABR or any of the other 23 Member Boards by visiting www.CertificationMatters.org or by calling toll-free 1-866-ASK-ABMS.
1Pearce MS et al. Lancet DOI 10.1016/S0140-0736(12)60815-0.
Established in 1934, the mission of the American Board of Radiology (ABR) is to serve patients, the public, and the medical profession by certifying that its diplomates have acquired, demonstrated, and maintained a requisite standard of knowledge, skill, understanding, and performance essential to the safe and competent practice of diagnostic radiology, radiation oncology, and medical physics. The ABR is one of 24 Member Boards of the American Board of Medical Specialties. For more information, go to www.theabr.org.
Established in 2004, the mission of the ABR Foundation (ABRF) is to demonstrate, enhance, and continuously improve accountability to the public in the use of medical imaging and radiation therapy. ABRF’s plan is to convene an inclusive public/private/professional effort with sole focus on serving the public good in the use of medical imaging and radiation therapy. In August 2012, the ABRF will conduct its third national healthcare summit: Safe Use in Medical Imaging: Developing a Systematic and Patient-Centered Approach, to identify and address quality and safety opportunities in medical imaging. For more information, go to www.abrfoundation.org.
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