Radiologists at Cincinnati Children’s take very seriously your child’s imaging needs and work in a number of ways to ensure that the right test has been ordered for the right reasons. Every x-ray picture, procedure or scan done in our Radiology Department is reviewed by a radiologist before it is completed. The imaging equipment that is used at Cincinnati Children’s is specifically designed for reducing risks and safely imaging children.
Recently, Dr. Wendy Pomerantz, an emergency room physician at Cincinnati Children’s, presented her research showing that pediatricians may be ordering too many CTs. Her study presented pediatricians with three scenarios of children with head injuries and evaluated their decision-making processes and likelihood of ordering a head CT scan for further evaluation. Many pediatricians (40% in one scenario) in the study ordered a CT scan even though the “odds of finding bleeding or a treatable situation were extremely unlikely.”
While this research suggests that pediatricians might need more guidance on when it is appropriate to evaluate head injuries for more significant medical concerns, our local experience suggests that pediatricians in Cincinnati are ordering CTs more appropriately. Over the past 5 years, the number of head CTs performed at Cincinnati Children’s has decreased from 6,180 studies in 2009 to 4,307 studies in 2013. We believe that the decrease in CT scans is mainly due to an increased awareness of the potential risks of radiation exposure. This increased awareness can be attributed to the Image Gently campaign, an international radiation awareness campaign run from Cincinnati Children’s since 2008.
In addition to helping to teach pediatricians of the risks of radiation exposure, radiologists at Cincinanti Children’s also play an active role in determining the best study for your child. When any CT is ordered, the radiologist first checks to make sure that this is the correct test. If it is not the correct test, the radiologist discusses the different options with your doctor and together, we make a decision on the best way to answer your doctor’s question. If a CT does need to be performed, the radiologist protocols the study, tailoring it specifically for your child so that we can answer the question your doctor is trying to answer. In the situation where we decide that a CT scan is the best test to make sure that your child’s head injury is not more serious, you can be reassured that we use the lowest possible radiation dose to perform the important and necessary imaging.
Pediatricians are often on the front lines when addressing concerns related to head injuries and head concussions. They are using their best judgment and experience to diagnosis and treat your child. Part of that care may be a head CT scan to better evaluate or confirm the diagnosis. Radiologists at Cincinnati Children’s are experts in imaging and we partner with your doctors to provide the best possible and safest care for every child. When it comes to head CT scans, that level of expertise and team approach is what we call a “no brainer.”
Written by Dr. Alan Brody and edited by Catherine Leopard.