Pediatric CT scan usage in Japan: results of a hospital survey.
OBJECTIVE
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.


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.


CONCLUSIONS
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.
Ghotbi
Nader
N
Department 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
Ohtsuru
Akira
A
Ogawa
Yoji
Y
Morishita
Mariko
M
Norimatsu
Nana
N
Namba
Hiroyuki
H
Moriuchi
Hiroyuki
H
Uetani
Masataka
M
Yamashita
Shunichi
S
D000293:Adolescent; D001064:Appendicitis / Q000000981:diagnostic imaging; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D010372:Pediatrics / Q000706:statistics & numerical data*; D011829:Radiation Dosage; D011872:Radiology Department, Hospital / Q000592:standards; D012189:Retrospective Studies; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000592:standards / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology