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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticlePatient Safety

Noncontrast Head CT in Children: National Variation in Radiation Dose Indices in the United States

G. Sadigh, N. Kadom, P. Karthik, D. Sengupta, K. J. Strauss, D. Frush and K.E. Applegate
American Journal of Neuroradiology July 2018, DOI: https://doi.org/10.3174/ajnr.A5719
G. Sadigh
aFrom the Department of Radiology and Imaging Sciences (G.S., N.K.,), Emory University School of Medicine, Atlanta, Georgia
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N. Kadom
aFrom the Department of Radiology and Imaging Sciences (G.S., N.K.,), Emory University School of Medicine, Atlanta, Georgia
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P. Karthik
bAmerican College of Radiology (P.K., D.S.), Reston, Virginia
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D. Sengupta
bAmerican College of Radiology (P.K., D.S.), Reston, Virginia
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K. J. Strauss
cDepartment of Radiology (K.J.S.), University of Cincinnati School of Medicine, Cincinnati, Ohio
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D. Frush
dDepartment of Radiology (D.F.), Duke University Medical Center, Durham, North Carolina
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K.E. Applegate
eDepartment of Radiology (K.E.A.), University of Kentucky, Lexington, Kentucky.
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References

  1. 1.↵
    1. Miglioretti DL,
    2. Johnson E,
    3. Williams A, et al
    . The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk. JAMA Pediatr 2013;167:700–07 doi:10.1001/jamapediatrics.2013.311 pmid:23754213
    CrossRefPubMed
  2. 2.↵
    1. Mettler FA Jr.,
    2. Wiest PW,
    3. Locken JA, et al
    . CT scanning: patterns of use and dose. J Radiol Prot 2000;20:353–59 doi:10.1088/0952-4746/20/4/301 pmid:11140709
    CrossRefPubMed
  3. 3.↵
    1. Wildman-Tobriner B,
    2. Strauss KJ,
    3. Bhargavan-Chatfield M, et al
    . Using the American College of Radiology Dose Index Registry to evaluate practice patterns and radiation dose estimates of pediatric body CT. AJR Am J Roentgenol 2018;210:641–47 doi:10.2214/AJR.17.18122 pmid:29323552
    CrossRefPubMed
  4. 4.↵
    1. Mettler FA Jr.,
    2. Thomadsen BR,
    3. Bhargavan M, et al
    . Medical radiation exposure in the U.S. in 2006: preliminary results. Health Phys 2008;95:502–07 doi:10.1097/01.HP.0000326333.42287.a2 pmid:18849682
    CrossRefPubMedWeb of Science
  5. 5.↵
    1. Marin JR,
    2. Sengupta D,
    3. Bhargavan-Chatfield M, et al
    . Variation in pediatric cervical spine computed tomography radiation dose index. Acad Emerg Med 2015;22:1499–505 doi:10.1111/acem.12822 pmid:26568459
    CrossRefPubMed
  6. 6.↵
    1. Larson DB,
    2. Johnson LW,
    3. Schnell BM, et al
    . Rising use of CT in child visits to the emergency department in the United States, 1995–2008. Radiology 2011;259:793–801 doi:10.1148/radiol.11101939 pmid:21467249
    CrossRefPubMedWeb of Science
  7. 7.↵
    1. Hollingworth W,
    2. Vavilala MS,
    3. Jarvik JG, et al
    . The use of repeated head computed tomography in pediatric blunt head trauma: factors predicting new and worsening brain injury. Pediatr Crit Care Med 2007;8:348–56; CEU quiz 357 doi:10.1097/01.PCC.0000270837.66217.3B pmid:17545925
    CrossRefPubMedWeb of Science
  8. 8.↵
    1. Statler KD,
    2. Keenan H
    . How many are too many? Repeat head computed tomography after traumatic brain injury. Pediatr Crit Care Med 2007;8:402–03 doi:10.1097/01.PCC.0000269388.26483.55 pmid:17622925
    CrossRefPubMed
  9. 9.↵
    1. Pearce MS,
    2. Salotti JA,
    3. Little MP, et al
    . Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet 2012;380:499–505 doi:10.1016/S0140-6736(12)60815-0 pmid:22681860
    CrossRefPubMedWeb of Science
  10. 10.↵
    1. Boice JD Jr.
    . Radiation epidemiology and recent paediatric computed tomography studies. Ann ICRP 2015;44:236–48 doi:10.1177/0146645315575877 pmid:25816281
    CrossRefPubMed
  11. 11.↵
    The National Academics. Beir VII: Health Risks from Exposure to Low Levels of Ionizing Radiation. https://www.nap.edu/read/11340/chapter/1. Accessed June 10, 2018
  12. 12.↵
    1. Mathews JD,
    2. Forsythe AV,
    3. Brady Z, et al
    . Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians. BMJ 2013;346:f2360 doi:10.1136/bmj.f2360 pmid:23694687
    Abstract/FREE Full Text
  13. 13.↵
    1. Yuan MK,
    2. Tsai DC,
    3. Chang SC, et al
    . The risk of cataract associated with repeated head and neck CT studies: a nationwide population-based study. AJR Am J Roentgenol 2013;201:626–30 doi:10.2214/AJR.12.9652 pmid:23971456
    CrossRefPubMed
  14. 14.↵
    1. Bernier MO,
    2. Journy N,
    3. Villoing D, et al
    . Cataract risk in a cohort of U.S. radiologic technologists performing nuclear medicine procedures. Radiology 2018;286:592–601 doi:10.1148/radiol.2017170683 pmid:29019450
    CrossRefPubMed
  15. 15.↵
    1. Nakashima E,
    2. Neriishi K,
    3. Minamoto A
    . A reanalysis of atomic-bomb cataract data, 2000–2002: a threshold analysis. Health Phys 2006;90:154–60 doi:10.1097/01.HP.0000175442.03596.63 pmid:16404173
    CrossRefPubMedWeb of Science
  16. 16.↵
    1. Gardavaud F,
    2. Luciani A,
    3. Rahmouni A
    . CT scans in childhood and risk of leukaemia and brain tumours. Lancet 2012;380:1735; author reply 1736–37 doi:10.1016/S0140-6736(12)61981-3 pmid:23158243
    CrossRefPubMed
  17. 17.↵
    1. Zopf DA,
    2. Green GE
    . CT scans in childhood and risk of leukaemia and brain tumours. Lancet 2012;380:1735–36; author reply 1736–37
    CrossRefPubMed
  18. 18.↵
    United States Nuclear Regulatory Commission. Radiation Exposure and Cancer. https://www.nrc.gov/about-nrc/radiation/health-effects/rad-exposure-cancer.html. Accessed February 4, 2018
  19. 19.↵
    1. King MA,
    2. Kanal KM,
    3. Relyea-Chew A, et al
    . Radiation exposure from pediatric head CT: a bi-institutional study. Pediatr Radiol 2009;39:1059–65 doi:10.1007/s00247-009-1327-1 pmid:19554322
    CrossRefPubMed
  20. 20.↵
    1. Kanal KM,
    2. Vavilala MS,
    3. Raelson C, et al
    . Variation in pediatric head CT imaging protocols in Washington state. J Am Coll Radiol 2011;8:242–50 doi:10.1016/j.jacr.2010.11.005 pmid:21458762
    CrossRefPubMed
  21. 21.↵
    1. Kanal KM,
    2. Graves JM,
    3. Vavilala MS, et al
    . Variation in CT pediatric head examination radiation dose: results from a national survey. AJR Am J Roentgenol 2015;204:W293–301 doi:10.2214/AJR.14.12997 pmid:25714315
    CrossRefPubMed
  22. 22.↵
    1. Graves JM,
    2. Kanal KM,
    3. Rivara FP, et al
    . Dose reduction efforts for pediatric head CT imaging in Washington State trauma centers: follow-up survey results. J Am Coll Radiol 2014;11:161–68 e3 doi:10.1016/j.jacr.2013.07.004 pmid:24360905
    CrossRefPubMed
  23. 23.↵
    1. Kanal KM,
    2. Butler PF,
    3. Sengupta D, et al
    . U.S. diagnostic reference levels and achievable doses for 10 adult CT examinations. Radiology 2017;284:120–33 doi:10.1148/radiol.2017161911 pmid:28221093
    CrossRefPubMed
  24. 24.↵
    American College of Radiology. Dose Index Registry. http://www.acr.org/Quality-Safety/National-Radiology-Data-Registry/Dose-Index-Registry. Accessed October 13, 2017
  25. 25.↵
    1. Morin RL,
    2. Coombs LP,
    3. Chatfield MB
    . ACR Dose Index Registry. J Am Coll Radiol 2011;8:288–91 doi:10.1016/j.jacr.2010.12.022 pmid:21458770
    CrossRefPubMed
  26. 26.↵
    American Association of Physicist in Medicine. The Measurement, Reporting, and Management of Radiation Dose in CT. Report of AAPM Task Group 23 of the Diagnostic Imaging Council CT Committee. January 2008. https://www.aapm.org/pubs/reports/RPT_96.pdf. Accessed January 25, 2018
  27. 27.↵
    U.S. Census Bureau. Census Regions and Divisions of the United States. http://www2.census.gov/geo/pdfs/maps-data/maps/reference/us_regdiv.pdf. Accessed October 13, 2017
  28. 28.↵
    1. Ginde AA,
    2. Foianini A,
    3. Renner DM, et al
    . Availability and quality of computed tomography and magnetic resonance imaging equipment in U.S. emergency departments. Acad Emerg Med 2008;15:780–83 doi:10.1111/j.1553-2712.2008.00192.x pmid:18783491
    CrossRefPubMedWeb of Science
  29. 29.↵
    Image Gently. Image Gently launches the Think-A-head Campaign. https://rpop.iaea.org/RPOP/RPoP/Content/News/10-Image_Gently.htm. Accessed October 19, 2017
  30. 30.↵
    1. Jaffe TA,
    2. Yoshizumi TT,
    3. Toncheva G, et al
    . Radiation dose for body CT protocols: variability of scanners at one institution. AJR Am J Roentgenol 2009;193:1141–47 doi:10.2214/AJR.09.2330 pmid:19770340
    CrossRefPubMedWeb of Science
  31. 31.↵
    1. Mayo-Smith WW,
    2. Hara AK,
    3. Mahesh M, et al
    . How I do it: managing radiation dose in CT. Radiology 2014;273:657–72 doi:10.1148/radiol.14132328 pmid:25420167
    CrossRefPubMed
  32. 32.↵
    1. Brink M,
    2. de Lange F,
    3. Oostveen LJ, et al
    . Arm raising at exposure-controlled multidetector trauma CT of thoracoabdominal region: higher image quality, lower radiation dose. Radiology 2008;249:661–70 doi:10.1148/radiol.2492080169 pmid:18936319
    CrossRefPubMedWeb of Science
  33. 33.↵
    1. Campbell J,
    2. Kalra MK,
    3. Rizzo S, et al
    . Scanning beyond anatomic limits of the thorax in chest CT: findings, radiation dose, and automatic tube current modulation. AJR Am J Roentgenol 2005;185:1525–30 doi:10.2214/AJR.04.1512 pmid:16304007
    CrossRefPubMedWeb of Science
  34. 34.↵
    1. Harri PA,
    2. Moreno CC,
    3. Nelson RC, et al
    . Variability of MDCT dose due to technologist performance: impact of posteroanterior versus anteroposterior localizer image and table height with use of automated tube current modulation. AJR Am J Roentgenol 2014;203:377–86 doi:10.2214/AJR.13.11608 pmid:25055274
    CrossRefPubMed
  35. 35.↵
    1. Borders HL,
    2. Barnes CL,
    3. Parks DC, et al
    . Use of a dedicated pediatric CT imaging service associated with decreased patient radiation dose. J Am Coll Radiol 2012;9:340–43 doi:10.1016/j.jacr.2011.12.027 pmid:22554632
    CrossRefPubMed
  36. 36.↵
    1. Goske MJ,
    2. Applegate KE,
    3. Boylan J, et al
    . The ‘Image Gently’ campaign: increasing CT radiation dose awareness through a national education and awareness program. Pediatr Radiol 2008;38:265–69 doi:10.1007/s00247-007-0743-3 pmid:18202842
    CrossRefPubMed
  37. 37.↵
    1. Goske MJ,
    2. Applegate KE,
    3. Boylan J, et al
    . The Image Gently campaign: working together to change practice. AJR Am J Roentgenol 2008;190:273–74 doi:10.2214/AJR.07.3526 pmid:18212208
    CrossRefPubMedWeb of Science
  38. 38.↵
    1. Strauss KJ,
    2. Goske MJ,
    3. Kaste SC, et al
    . Image Gently: ten steps you can take to optimize image quality and lower CT dose for pediatric patients. AJR Am J Roentgenol 2010;194:868–73 doi:10.2214/AJR.09.4091 pmid:20308484
    CrossRefPubMedWeb of Science
  39. 39.↵
    American College of Radiology. Appropriateness Criteria. https://acsearch.acr.org/list. Accessed January 25, 2018
  40. 40.↵
    1. Kleinman PL,
    2. Strauss KJ,
    3. Zurakowski D, et al
    . Patient size measured on CT images as a function of age at a tertiary care children's hospital. AJR Am J Roentgenol 2010;194:1611–19 doi:10.2214/AJR.09.3771 pmid:20489103
    CrossRefPubMedWeb of Science
  41. 41.↵
    1. Bohl M
    . Dose Index Registry Exam Name Mapping Review Made Easy. https://wwwlinkedincom/pulse/dose-index-registry-exam-name-mapping-review-made-easy-michael-bohl/ 2017. Accessed April 13, 2018
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Cite this article
G. Sadigh, N. Kadom, P. Karthik, D. Sengupta, K. J. Strauss, D. Frush, K.E. Applegate
Noncontrast Head CT in Children: National Variation in Radiation Dose Indices in the United States
American Journal of Neuroradiology Jul 2018, DOI: 10.3174/ajnr.A5719

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Noncontrast Head CT in Children: National Variation in Radiation Dose Indices in the United States
G. Sadigh, N. Kadom, P. Karthik, D. Sengupta, K. J. Strauss, D. Frush, K.E. Applegate
American Journal of Neuroradiology Jul 2018, DOI: 10.3174/ajnr.A5719
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