The utilization of pediatric computed tomography in a large Israeli Health Maintenance Organization

Area of Science:

• Medical Imaging
• Pediatric Radiology
• Radiation Safety

Background:

• Growing concerns exist regarding radiation exposure risks from computed tomography (CT) scans in children.
• Limited data are available on the extent of pediatric CT scan usage.

Purpose of the Study:

• To investigate patterns in pediatric CT scan utilization.
• Analysis focused on temporal trends, repeat scans, body regions examined, and associated medical diagnoses.

Main Methods:

• Retrospective analysis of 22,223 CT scans performed on 18,075 individuals aged 18 years or younger.
• Data were collected from a large Israeli Health Maintenance Organization between 1999 and 2003.
• Diagnoses were recorded within 21 days of the CT examination.

Main Results:

• The peak annual CT examination rate per 1,000 children was observed in 2001 (10.1), with rates of 7.0 in 1999 and 6.3 in 2003.
• CT utilization rates increased with age, with the lowest rate (3 scans per 1,000) found in 3-year-olds.
• The head was the most frequently imaged region (78% in young children, 39% in adolescents).
• Ill-defined conditions and injuries accounted for 22% and 10% of diagnoses, respectively.

Conclusions:

• Children represent approximately 3% of all patients undergoing CT scans.
• Despite lower utilization, CT scans require cautious application in pediatric populations.
• Children's increased radiosensitivity, higher effective radiation doses, and longer life expectancy necessitate careful consideration of CT use.