Paediatric CT imaging trends in Australia

Brady, Zoe; Cain, Tim; Johnston, Peter

doi:10.1111/j.1754-9485.2011.02242.x

Cited by 48 publications

(53 citation statements)

References 23 publications

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“…The increase in CT and MRI usage may be attributed to a number of factors: increased staffing, technological advances leading to increased diagnostic efficacy and faster scanning times, patient-and physician-generated demand and defensive medical practices and medical uncertainty. 4,[20][21][22] Although a number of studies support our finding of an increase in the volume of CT performed in the paediatric population over time, 2,13,[17][18][19] Townsend et al 23 recently reported a reduction in the use of CT as a proportion of all cross-sectional imaging studies from 2003 to 2007 in paediatric facilities across North America. However, this study did not provide imaging rates.…”

Section: Discussionsupporting

confidence: 54%

“…3,13 Older studies have published national paediatric CT data from Australia, the UK, Israel and Germany. 2,[17][18][19] To date, we present the Over a 10-year period, 224,173 advanced imaging examinations were carried out, an average of 2.7 examinations per person. As expected, ultrasound was by far the most utilized modality in our study, followed by MRI, CT and NM.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Advanced imaging modalities used in paediatric radiology include ultrasound, CT, MRI and nuclear medicine (NM). 4 The quest for safer, more accurate and interpretive-efficient diagnoses has driven technological advances in imaging.…”

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confidence: 99%

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A review of cross-sectional imaging, ultrasound and nuclear medicine utilization patterns in paediatric patients in Ireland, 2003–12

O’Connor

Ryan²,

Foley³

2015

BJR

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Objective: Recent trends in paediatric imaging have been examined in Australia and the USA. Such literature in Europe is sparse, incomprehensive and outdated. This research investigated (1) population-based trends in the use of advanced medical imaging in children in Ireland from 2003 to 2012; (2) its use across age and gender; and (3) the most commonly performed examinations within each modality. Methods: A retrospective cohort analysis study was carried out within Irish paediatric hospitals. All CT, MRI, ultrasound and nuclear medicine (NM) annual examination data from 2003 to 2012 was obtained from radiology information systems. Results: 224,173 imaging procedures were carried out on 84,511 patients, 68% of which were ultrasound, 15% were MRI, 11% were CT and 6% were NM. Between 2003 and 2012, MRI (1280%) and CT (180%) saw the largest increases in use, followed by ultrasound (167%) and NM (110%). Almost half of the study population were less than 3 years old. CT imaging was more frequent than MR in 2005. By 2012, MR rates were twice that of CT. CT imaging rates were the lowest in the youngest age categories. Conclusion: Advanced imaging use, particularly MRI, has risen substantially over the past 10 years. The utilization of non-ionizing modalities increased between 2003 and 2012, especially in brain, spinal and abdominal imaging. MR is now used at twice the frequency of CT. Advances in knowledge: Longitudinal advanced imaging utilization trends, including CT trends, have been established in the Irish paediatric population.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

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A review of cross-sectional imaging, ultrasound and nuclear medicine utilization patterns in paediatric patients in Ireland, 2003–12

O’Connor

Ryan²,

Foley³

2015

BJR

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“…The figure is unlikely to be as low as 0 % or as high as 70 %, but it is clear that this issue is significant. Analysis of Medicare records confirms that Australian CT imaging rates are increasing, with an annual growth rate of 8.5 % [1]. Additionally, a recent international survey found that CT accounts for almost half of the collective population dose from diagnostic procedures (43 %) while constituting less than 10 % of the number of procedures performed [2].…”

mentioning

confidence: 99%

A Computed Tomography (CT) wish list, from a medical physicist’s perspective

Brady

Einsiedel

2012

Australas Phys Eng Sci Med

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Significant advances in computed tomography (CT) technology have been made since the first clinical images were published in 1973. The initial clinical applications were brain scans where the patient's head was immobilised by a water bag that compensated for the large changes in flux adjacent to the head. Body imaging became feasible as improvements led to better image quality and reduced scan times. Improved computing technology has allowed for image reconstruction, including rendering and 3D reconstruction, to all occur in real time. Perfusion studies, cardiac imaging and CT angiography are now common and interventional procedures can be performed using CT fluoroscopy guidance. Some of the major scanner developments that have contributed to this progress are slip-ring technology, which facilitated helical scanning, and multidetector CT systems with capabilities for volume scanning. In addition, increasingly complex X-ray tube designs and novel CT detector materials and configurations have also contributed to changes in CT imaging. Dose reporting began to address concerns raised regarding the risks from radiation exposure and other practical dose reduction measures such as the adaptation of parameters to the patient size were implemented. This included modulating the tube current throughout the scan. More recent CT developments include dual-energy imaging and iterative reconstruction techniques, which are used instead of or in combination with traditional filtered back-projection image formation. All of these improvements in technologies combined have resulted in dose reductions for some CT procedures in the order of 90 %! The changes to image quality, dose and the way in which CT scans are performed have been extensive. However, there are always further enhancements that can be made, especially as user requirements or objectives change. For diagnostic medical physicists, there will always be a wish list of what we would like on a CT scanner. This is largely driven by the work that we undertake and the needs of our colleagues, who request, perform or interpret CT scans. Inevitably, achieving the best health outcome for the patient is the primary concern. The wish list is also influenced by current opinions and attitudes towards CT imaging. Hence, the desirable features for a CT scanner are discussed below, with the rationale for these first explored. A small straw poll of radiologists and radiographers from a variety of workplaces was also undertaken to gauge opinions.

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“…Pediatric CT use has increased in many countries over the last years [4,5,6,7]. However, recent data suggest that pediatric CT use may be declining in some developed countries [8,9,10].…”

Section: Introductionmentioning

confidence: 99%

Patterns and trends of Computed Tomography usage among pediatric and young adult patients in a private hospital in Rio de Janeiro, 2005-2015

Chaves¹,

Dovales²,

Rosa³

et al. 2018

Braz. J. Rad. Sci.

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Computed tomography (CT) scanning is a relatively high-dose procedure which use has been rapidly increasing in many countries, although a decline has been observed recently in some developed countries. Relatively little is known about CT usage in Brazil. A recent report showed that number of CT procedures among outpatients of the Brazilian public healthcare system (SUS) tripled from 2001 to 2011 and about 13% of all CTs procedures were performed in pediatric and young adult patients. In the present study, we aimed to evaluate CT use in the private healthcare system, where the larger availability of CT scanners may result in a different CT usage pattern. We evaluated data from 15,892 CT procedures underwent by children and young adults (<20 years) between 2005 and 2015 in a private general hospital in the city of Rio de Janeiro. These procedures represented about 8% of the overall number of CT scans in the hospital over the study period. The number of CT examinations increased 10% per year, from 902 in 2005 to 2,376 in 2015. Head/neck was the most frequently examined body anatomical region for all age groups, except for patients aged 15-19 years for whom abdomen/pelvis was the most common scanned region. One third of the patients underwent more than one CT examination in the study hospital, with multiple CT exams increasing with patient age. The greater availability of other diagnostic imaging examinations in the private setting, such as magnetic resonance and ultrasound, could have contributed to the lower proportion of pediatric and young adult CT in the study hospital. The rapid increase of pediatric CT usage in the public and private healthcare setting reinforces the need for initiatives to avoid unwarranted CT exposure in Brazil.

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Paediatric CT imaging trends in Australia

Abstract: The significant growth in CT services is attributable to increased demand from the adult demographic. Conversely, increases in the imaging rate for paediatric patients have slowed overall. In fact, for some age groups the rate has fallen.

Cited by 48 publications

References 23 publications

A review of cross-sectional imaging, ultrasound and nuclear medicine utilization patterns in paediatric patients in Ireland, 2003–12

A review of cross-sectional imaging, ultrasound and nuclear medicine utilization patterns in paediatric patients in Ireland, 2003–12

A Computed Tomography (CT) wish list, from a medical physicist’s perspective

Patterns and trends of Computed Tomography usage among pediatric and young adult patients in a private hospital in Rio de Janeiro, 2005-2015

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