Are facilities following best practices of pediatric abdominal CT scans?
BACKGROUND
Established guidelines for pediatric abdominal CT scans include reduced radiation dosage to minimize cancer risk and the use of intravenous (IV) contrast to obtain the highest-quality diagnostic images. We wish to determine if these practices are being used at nonpediatric facilities that transfer children to a pediatric facility.


METHODS
Children transferred to a tertiary pediatric facility over a 16-mo period with abdominal CT scans performed for evaluation of possible appendicitis were retrospectively reviewed for demographics, diagnosis, radiation dosage, CT contrast use, and scan quality. If CT scans were repeated, the radiation dosage between facilities was compared using Student t-test.


RESULTS
Ninety-one consecutive children transferred from 29 different facilities had retrievable CT scan images and clinical information. Half of CT scans from transferring institutions used IV contrast. Due to poor quality or inconclusive CT scans, 19 patients required a change in management. Children received significantly less radiation at our institution compared to the referring adult facility for the same body area scanned on the same child (9.7 mSv versus 19.9 mSv, P = 0.0079).


CONCLUSIONS
Pediatric facilities may be using less radiation per CT scan due to a heightened awareness of radiation risks and specific pediatric CT scanning protocols. The benefits of IV contrast for the diagnostic yield of pediatric CT scans should be considered to obtain the best possible image and to prevent additional imaging. Every facility performing pediatric CT scans should minimize radiation exposure, and pediatric facilities should provide feedback and education to other facilities scanning children.
State University of New York at Buffalo, School of Medicine, Buffalo, NY 14222, USA.
Amy E
AE
Nosek
Charles W
CW
Hartin
Kathryn D
KD
Bass
Philip L
PL
Glick
Michael G
MG
Caty
Merril T
MT
Dayton
Doruk E
DE
Ozgediz
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D011860:Radiography, Abdominal; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*