Children’s Radiation Exposure: Gentler Imaging for Kids

With Marvin Nelson, M.D.

children's radiation exposureWhen children are injured or ill, medical imaging can give doctors important information to help make kids well. But whether that’s an X-ray of a possibly fractured limb, a chest X-ray to check for pneumonia or a more advanced CT or PET scan, these procedures expose children to radiation.

Marvin Nelson, M.D., is chairman of the department of radiology at Children’s Hospital Los Angeles, where they perform as many as 130,000 imaging exams a year and also offer imaging through outpatient clinics. He suggests parents visit the Image Gently website (www.imagegently.org) to learn more about keeping children’s radiation exposure to a minimum. He also offers additional information and tips.

Why should we be concerned about our children’s exposure to radiation?

Children are still developing, so everybody is concerned that exposure to large amounts of radiation can ultimately cause leukemia or cancer in some form later on in life.

But imaging can be an important tool, right?

When kids are sick, you need to get the information to get them well as quick as possible, so I don’t think that you should be afraid of having an imaging study done on your child if it’s medically indicated. But you want to make sure that it’s done correctly and done in the proper way when it is needed.

Can you put radiation exposure from imaging into real-world context for us?

A chest X-ray would be equivalent to about one normal day of our background radiation. A CT scan of the head would be about eight months of background radiation, and a CT scan of the abdomen would be about 20 months of background radiation.

Why is it that different types of imaging procedures expose people to different levels of radiation?

A plain X-ray is just shooting the beam once and getting it across to the detector to make the image. A CT scan is like taking thousands of images to reconstruct what the inside of your body looks like. It’s a beam that passes through your body as it continuously goes around.

Does exposure vary with the individual piece of equipment?

That can vary quite a bit. For instance, newer CT scanners have software that allows us to use much, much, much lower doses to make the same quality of images. And all these machines can be adjusted to lower the doses specifically for children. Kids that happen to venture into places that mostly do adults, that don’t know how to adjust the doses down, often end up getting exposed to adult levels of radiation when they don’t need to be. It’s critical for the parents to ask ahead of time, “Are you adjusting the dosage for a child?”

If a parent is told their child needs to have an imaging procedure done, what other questions should they ask?

I think it’s important that they ask if they have pediatric radiologists looking at the imaging studies and interpreting them. It means they have doctors who know about the diseases that happen in kids, because they’re very different than adult diseases.

Our technicians are trained specifically to work with children of all sizes. And we also have equipment we’ve modified specifically to make it safer and more appropriate for children. Also, sometimes for MRI scans or for long CT scans, children need to hold perfectly still to get the proper images. Going to a pediatric facility where we have people who know what they are doing when children need to be sedated so they can hold still is extremely important.

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