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Pediatric CT scan usage in Japan: results of a hospital survey
Nader Ghotbi1, Akira Ohtsuru, Yoji Ogawa
1Department of Molecular Medicine, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan. naderq@gmail.com
Insights
Japanese hospitals may be overusing computed tomography (CT) scans in children, particularly for minor head trauma and suspected appendicitis. Radiation risks necessitate careful consideration and adherence to diagnostic guidelines to prevent unnecessary CT examinations.
Area of Science:
- Pediatric radiology
- Medical imaging safety
- Radiation protection in children
Background:
- Concerns exist regarding the overuse of diagnostic computed tomography (CT) in pediatric patients within Japanese hospitals.
- Understanding the specific usage parameters, including technical settings and clinical indications, is crucial for assessing potential overuse.
Purpose of the Study:
- To examine the usage parameters of diagnostic CT in children in Japanese hospitals.
- To investigate both technical CT exposure settings and clinical grounds for CT requests.
- To address concerns about potential overuse of CT in pediatric diagnostics.
Main Methods:
- Retrospective study of pediatric CT requests over a 1-year period at Nagasaki University Hospital.
- Detailed analysis of CT usage parameters for minor head trauma and acute appendicitis.
- Examination of institutional radiology department methodologies for reducing pediatric radiation exposure.
Main Results:
- CT radiation dose settings in Japan are adjusted for children per guidelines, with minimal limitations.
- CT scans were requested for 62% of minor head trauma and 76% of suspected acute appendicitis cases.
- These utilization rates exceed those reported in the UK, Canada, and the US, with no specific guidelines for minor head trauma CT and routine confirmation CT for appendicitis.
Conclusions:
- The radiation risks associated with CT scans in children in Japanese hospitals require serious attention.
- Physicians should be encouraged to adopt diagnostic algorithms to minimize unnecessary CT utilization in pediatric patients.
- A critical evaluation of current CT practices is needed to ensure appropriate use and mitigate potential harm.
Purpose:
The aim of this study was to examine the usage parameters of diagnostic computed tomography (CT) in children because of concerns of possible overuse in Japanese hospitals, including the "technical" CT exposure settings and the "clinical" grounds for CT requests.
Materials And Methods:
We examined the methodology at the radiology department to reduce radiation exposure to children and performed a retrospective study on pediatric CT requests during a 1-year period at Nagasaki University Hospital. The parameters of diagnostic CT usage for minor head trauma and acute appendicitis were studied in detail.
Results:
CT radiation dose settings are adjusted for children based on guidelines issued by the Japan Radiological Society, with few limitations. CT requests were made for 62% of minor head trauma cases and 76% of cases clinically suspected to be acute appendicitis. These figures are considerably higher than those reported by studies in the United Kingdom, Canada, or the United States. No specific guidelines are advocated regarding CT usage for minor head trauma. The diagnosis of acute appendicitis in children is almost routinely referred for "confirmation" by CT.
Conclusion:
CT radiation risks to children at Japanese hospitals need to be considered more seriously. Physicians should be encouraged to follow diagnostic algorithms that help avoid unnecessary CT usage in children.
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