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Radiologists work to limit kids’ exposure to radiation

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Dr. Alan Nazerian, medical director of pediatric radiology, next to Edward Hospital's newest CT scanner. | Submitted

By the numbers

Radiation exposure in adults:

Suggested annual limit: 5 rem

Typical annual radiation from natural background sources: 3 mrem (3/10th of a rem)

Typical X-ray exposure: < 10 mrem

Image Wisely (www.imagewisely.org) offers downloadable patient medical image record charts for adults and links to information on radiation risks and benefits.

Strategies for limiting
medical radiation:

Keep a record of when and where you’ve had medical images taken.

Always ask why the test is being ordered.

Ask if ultrasound or MRI is a viable alternative.

Request the lowest possible dose for your case.

To learn more about
pediatric radiation see:

Image Gently: www.pedrad.org/associations/5364/ig/

FDA website: www.fda.gov/Radiation-EmittingProducts/RadiationEmittingProductsandProcedures/MedicalImaging/ucm298899.htm

Updated: July 7, 2012 8:27AM



Parents in Naperville concerned about radiation their children might be exposed to should they need an X-ray or CT scan can rest easy. Local radiologists already are doing many of the recommendations included in a new FDA proposal to reduce kids’ exposure. They also can help balance the benefits and risks of radiology exams.

Ionizing radiation — the type used in CT scanners and X-ray machines — stays in the body for life. This cumulative effect, along with the radio-sensitivity of their growing bodies, puts children at a higher risk for potentially developing cancer or DNA damage from radiation (though the risk from a single scan is insignificant). With careful dosing, radiology exams can be done safely and effectively on children.

“There is probably a slight risk,” says Dr. Rajit Shetty of DuPage Medical Group’s radiology department. “But we always have to weigh it against the benefits of getting the test done.”

The largest part of the FDA’s proposal requires manufacturers of medical imaging equipment to provide settings and instructions for dosing appropriate to children. Edward Hospital, Rush-Copley Hospital and DuPage Medical Group all operate equipment with those modified settings. And all have completed or are in the process of accreditation with the American College of Radiology. This voluntary, rigorous process ensures, among other things, that the radiation emitted matches exactly to dosage settings on the equipment. ACR accreditation is an important signal to the public that a radiology department is meeting or exceeding health and safety standards.

“It’s an easy question to ask: ‘Is this facility ACR accredited’,” says Tom Markuszewski, director of imaging services at Rush-Copley Hospital. “Then you know a qualified medical physicist has checked the dosage on the equipment.”

For parents facing exams for their children, asking questions becomes a core part of limiting exposure to radiation. First and foremost, they should ask whether an exam using radiology is necessary.

Dr. Alan Nazerian, medical director of pediatric radiology at Edward Hospital, encourages parents to be advocates for their children.

“It’s OK for them to question the doctor,” Nazerian says. “Any physician should be aware that the parent is just being an advocate.”

A second question to ask is whether another technology could give the doctors the information they need to make a diagnosis. Ultrasounds and MRI’s do not use radiation and can sometimes be used in place of X-rays or CT scans, depending on the medical issue in question. Asking about alternatives puts the balance of benefits and risks in the forefront of the doctor’s or radiologist’s mind.

Markuszewski, Nazerian and Shetty also all recommend that parents keep a record of the X-rays and scans their children receive. Image Gently, an initiative of the Alliance for Radiation Safety in Pediatric Imaging, aims to help parents and medical personnel monitor and limit the amounts of medical radiation kids receive. They offer a downloadable medical image record form for parents to use — much like an immunization record.

Keeping a record allows doctors to make better decisions about when to hold off on imaging. And it can help children avoid repeat tests. Doctors can note opportunities to use images taken at another facility that they wouldn’t have been aware of otherwise.

Markuszewski and Nazerian note other developments that allow their departments to reduce radiation. At Rush-Copley, a transition from computed radiology to digital equipment has reduced radiation across the board. And Nazerian is awaiting new software that will provide a profile of the radiation dose given after each scan. With this information, doctors can calculate their patients’ exact radiation exposure over time.

Patients, pediatric and adult, should be comforted by both the FDA’s proposal and measures taken by local facilities. Doctors and radiologists want the best for their health, both now and in the future.

“Radiation does have some side effects,” Shetty says. “But for the vast majority of patients, the answers these tests provide can be life saving.”

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