title: Pediatric computed tomography practice in Japanese university hospitals from 2008-2010: did it differ from German practice?
abstract: Computed tomography (CT) is an essential tool in modern medicine and is frequently used to diagnose a wide range of conditions, particularly in industrial countries, such as Japan and Germany. However, markedly higher doses of ionizing radiation are delivered during CT imaging than during conventional X-ray examinations. To assess pediatric CT practice patterns, data from three university hospital databases (two in Japan and one in Germany) were analyzed. Anonymized data for patients aged 0 to 14 years who had undergone CT examinations between 2008 and 2010 were extracted. To assess CT practice, an interdisciplinary classification scheme for CT indications, which incorporated the most common examination types and radiosensitive tissues, was developed. The frequency of CT examinations was determined according to sex, age at examination, and indications. A total of 5182 CT examinations were performed in 2955 children. Overall, the frequency of CT examinations at the Japanese university hospitals did not differ significantly from that at the German hospital. However, differences were detected in the age distribution of the patients who underwent CT examinations (the proportion of patients <5 years of age was significantly higher in Japan than in Germany) and in the indications for CT. Substantial practice differences regarding the use of CT in pediatric health care were detected between the three hospitals. The results of this study point towards a need for approaches such as clinical guidelines to reduce unwarranted medical radiation exposures, particularly abdominal and head CT, in the Japanese health system.
authors.affiliation: Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan.|Education Center for Disaster Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: Section of Environment and Radiation, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon CEDEX 08, France.|Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1 D 55131, Mainz, Germany.
authors.forename: Lucian
authors.initials: L
authors.lastname: Krille
authors.affiliation: Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstrasse 30, 28359 Bremen, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Dreger
authors.affiliation: Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1 D 55131, Mainz, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Hoenig
authors.affiliation: Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1 D 55131, Mainz, Germany.
authors.forename: Hiltrud
authors.initials: H
authors.lastname: Merzenich
authors.affiliation: Education Center for Disaster Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan.
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Yasui
authors.affiliation: Education Center for Disaster Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kumagai
authors.affiliation: Department of Radiation Health Management, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Ohtsuru
authors.affiliation: Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Uetani
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1 D 55131, Mainz, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Mildenberger
authors.affiliation: Department of Global Health, Medicine and Welfare, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan.
authors.forename: Noboru
authors.initials: N
authors.lastname: Takamura
authors.affiliation: Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Yamashita
authors.affiliation: Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstrasse 30, 28359 Bremen, Germany.
authors.forename: Hajo
authors.initials: H
authors.lastname: Zeeb
authors.affiliation: Department of Radioisotope Medicine, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan tkudo123@nagasaki-u.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kudo
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005858:Germany; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan; D008297:Male; D010818:Practice Patterns, Physicians'; D014057:Tomography, X-Ray Computed
keywords: children; computed tomography; international comparison; ionizing radiation; practice pattern