Paediatric CT scan usage and referrals of children to computed tomography in Germany-a cross-sectional survey of medical practice and awareness of radiation related health risks among physicians

Abstract

BackgroundComputed tomography (CT) is a major source of ionizing radiation exposure in medical diagnostic. Compared to adults, children are supposed to be more susceptible to health risks related to radiation. The purpose of a cross-sectional survey among office-based physicians in Germany was the assessment of medical practice in paediatric CT referrals and to investigate physicians' knowledge of radiation doses and potential health risks of radiation exposure from CT in children.MethodsA standardized questionnaire was distributed to all paediatricians and surgeons in two defined study areas. Furthermore, the study population included a random sample of general practitioners in the two areas. The questionnaire covered the frequency of referrals for paediatric CT examinations, the medical diagnoses leading to paediatric CT referrals, physicians' knowledge of radiation doses and potential health risks of radiation exposure from CT in children.ResultsA total of 295 (36.4%) physicians responded. 59% of the doctors had not referred a child to CT in the past year, and approximately 30% referred only 1-5 children annually. The most frequent indications for a CT examination in children were trauma or a suspected cancer. 42% of the referrals were related to minor diagnoses or unspecific symptoms. The participants underestimated the radiation exposure due to CT and they overestimated the radiation exposure due to conventional X-ray examinations.ConclusionsIn Germany, the frequency of referrals of children to computed tomography is moderate. The knowledge on the risks from radiation exposure among office-based physicians in our sample varied, but there was a tendency to underestimate potential CT risks. Advanced radiological training might lead to considerable amendments in terms of knowledge and practice of CT referral.

Risk of radiation-induced malignancies from CT scanning in children who underwent shunt treatment before 6 years of age: a retrospective cohort study with a minimum 10-year follow-up

“…7,9,13,20,27,31,35 It makes intuitive sense that developing tissue is more sensitive. Indeed, prenatal exposure to radiation has been shown to increase childhood malignancy.…”

Frequency of paediatric medical imaging examinations performed at a European teaching hospital over a 7-year period

“…However, MI use within the paediatric population remains unclear, and the few published studies found mainly provide data detailing the use of MI on paediatric populations outside of Europe before the year 2010 [22,24,40] or else solely focus on the use of a single modality such as CT [23,25,38,[41][42][43][44][45]. It is in this context that we believe that our study findings provide a valid insight into recent trends occurring at a general hospital in Fig.…”

Estimation of effective doses in pediatric X‑ray computed tomography examination

“…In addition, it is difficult to accurately quantify the CT risk level that would require long-term follow-up of a majority of patients (16,17). Reports concerning risks and CT doses have indicated a low level of awareness and knowledge among medical staff (18,19). The present study may allow medical staff to understand and recognize the significance of a wide effective dose range that encompasses specific low-dose protocols to extended-coverage body scans.…”