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Kids, X-Rays and CAT Scans, Oh, My!
From:
Dr. Patricia A. Farrell -- Psychologist Dr. Patricia A. Farrell -- Psychologist
For Immediate Release:
Dateline: Tenafly, NJ
Friday, October 25, 2024

 

Detecting and treating specific diseases may require radiation-sensitive devices, and deciding on the risk/benefit ratio can be difficult.

Photo by National Cancer Institute on Unsplash

The monthly medical meeting was uneventful, with the usual information being dispensed under department regulations. All the healthcare providers waited for it to be over until one pediatrician stood up to tell the group something that troubled him.

"The other day, a mother and her child came into my office," he said, "and she praised the local clinic where her child had been receiving treatment. She said they were so good and so careful that each time she brought her child in, they took an x-ray of his body." This might have happened several times a year.

The physician turned and looked at the group, waiting for some response. There was none, and it seemed perfectly fine with everyone that this child was repeatedly being exposed to needless X-rays. It was an example of disregard for ethical norms or medical needs, especially with children.

Questions must be raised, and adequate answers must be given when any type of radiation is necessary for the detection or treatment of specific illnesses or diagnoses. Viewing this in any other way should be discouraged because patients have a right to know of any dangers or benefits that will accrue to them. Is this the case every time? Obviously, that was not the case in the illustration of the parent-physician interaction above. Patients also must wonder how many of these procedures in a year would be safe for them, and that's a reasonable request, too.

Ionizing radiation, which includes high-energy wavelengths or particles, is used in x-ray, computed tomography (CT), and nuclear imaging. This type of radiation can penetrate tissue and show the inside organs and structures of the body. Despite your cells’ best efforts, ionizing radiation can damage DNA. However, even their repairs are not always complete, and there may be small patches of “misrepair.” This causes DNA alterations, which can increase the risk of cancer in the future.

Pediatric Use and Risk

Among imaging modalities, computed tomography (CT) produces the highest radiation exposures, yet it is an effective diagnostic tool. Radiation shielding is crucial, especially for youngsters. One study looked at the possibility of brain tumors and leukemia in children exposed to low doses of ionizing radiation from CT scans.

The study concluded that exposure to radiation from CT scans increases the incidence of brain tumors in a retrospective cohort of 168,394 children in the Netherlands. Regarding leukemia, no correlation (i.e., no cause and effect) was found. It is important to exercise caution when interpreting the results because the sample of children who had CT scans displayed a higher incidence of brain tumors compared to the overall population. It was possibly a misrepresentative sample, but it could provide some evidence for additional caution with children.

In addition, patients who have computed tomographic (CT) scans before the age of 22 may be at a higher risk of developing blood malignancies. Research using data from about 900,000 youngsters in Europe who had at least one scan revealed an almost twofold increased excess risk per 100 mGy dosage.

At an average dose of 8 mGy per scan, these results imply that 1 to 2 children per 10,000 who get CT scans are likely to acquire a blood malignancy such as non-Hodgkin lymphoma or acute leukemia because of radiation.

In a European study, lower but still elevated risk estimates were obtained, especially for lymphoid malignancies, where the number of cases was lowered when the period of follow-up was limited to 2 years following the maximum age at first CT in each nation.

As indicated by other studies, concern remains. Despite the benefits, medical professionals are worried about cancer risk and reduced pediatric CTs due to high cumulative doses.

Adult Risk Considered

There were a total of twenty-five studies that utilized 111,649,943 participants, with a mean age of 45.37 years and an 83.4% female representation. Out of these, 2,049,943 were participants from six studies with participants ranging from 5 to 80 years. Following CT scans, the risk of cancer in adults was significantly elevated. Radiation exposure and the number of CT scan locations both raise the likelihood of cancer.

Study quality and time phrases were not significantly different from one study to another, nor were gender, age, nation, or continent. Were females more at risk, or did they receive more radiation through CT scans?

However, changes have come to the CT scan and radiation received by patients. Although CT scans pose little risk to patients, they expose them to small amounts of radiation. Patients subjected to higher radiation doses are those who require more frequent scans to track their health or who undergo specialist CT exams, such as CT perfusion (CTP).

Radiologists have a delicate balancing act to accomplish when deciding on a course of treatment: use a larger dose to acquire better quality images for diagnosis, or a lower dose to get lower quality images. Now, AI has entered healthcare and it is making a difference in CT scans.

CT scans continue to be an important diagnostic and treatment device, but healthcare professionals should use them only when there is a specific need and minimize the number of scans required. Research also shows that those with specific diseases may require more frequent scans and accumulate more radiation exposure during their lifetime (LAR).

Website: www.drfarrell.net

Author's page: http://amzn.to/2rVYB0J

Medium page: https://medium.com/@drpatfarrell

Twitter: @drpatfarrell

Attribution of this material is appreciated.

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Name: Dr. Patricia A. Farrell, Ph.D.
Title: Licensed Psychologist
Group: Dr. Patricia A. Farrell, Ph.D., LLC
Dateline: Tenafly, NJ United States
Cell Phone: 201-417-1827
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