The utilization of pediatric computed tomography in a large Israeli Health Maintenance Organization.
BACKGROUND
Concern has been raised about the potential risks related to radiation exposure from CT scans, particularly among children. However, to date, there are few data available describing the magnitude of pediatric CT utilization.


OBJECTIVE
The aim of the study was to explore patterns of CT use in pediatric patients, with respect to time, use of multiple scans, body regions imaged, and medical diagnoses.


METHODS
Records of 22,223 scans performed on 18,075 people aged < or =18 years over the period 1999-2003, including diagnoses recorded within 21 days after the examination, were obtained from a large Israeli Health Maintenance Organization (1,600,000 members).


RESULTS
The highest annual CT examination rate (per 1,000) was recorded in 2001 (10.1) compared to 7.0 and 6.3 in 1999 and 2003, respectively. The lowest rate (three scans per 1,000) was found for 3-year-old children, with increasing rates with age. The head was the most frequently scanned region, both in young children (78%) and adolescents (39%). Symptoms of ill-defined conditions and injuries were documented in 22% and 10% of all scans, respectively.


CONCLUSIONS
Although the results suggest that children comprise only 3% of all patients undergoing CT, this important modality must be carefully used because of their increased radiosensitivity, higher effective radiation doses, and longer life expectancy.
Maccabi Healthcare Services, 27 Ha'Mered Street, Tel Aviv, Israel. chodickg@mail.nih.gov
Gabriel
G
Chodick
Cécile
C
Ronckers
Elaine
E
Ron
Varda
V
Shalev
D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000706:statistics & numerical data; D019992:Databases as Topic; D005121:Extremities / Q000000981:diagnostic imaging; D005145:Face / Q000000981:diagnostic imaging; D006279:Health Maintenance Organizations; D006801:Humans; D007223:Infant; D007557:Israel; D009333:Neck / Q000000981:diagnostic imaging; D011860:Radiography, Abdominal; D012886:Skull / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*