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Brains & Sprains NEW
Benefits and Risks of Follow-Up Imaging
Y
by Cathy Hamilton
our soccer-obsessed 11-yearold daughter manages to run head-on into a teammate during practice. The teammate is OK, but your daughter’s vision is blurry and she complains of a blinding headache by the time she’s getting stitches for a cut in her scalp. The physician at urgent care wants to send her for a CT scan to check for concussion – but mentions something about radiation involved. Do you, the parent, say “Yes”? Or what about this: Your threeyear-old has sharp pain in his tummy after spending a day eating corn dogs and cotton candy at the county fair. The family doc thinks it might be acute appendicitis – and orders up a CT to help see whether that’s true. Do you sign the permission form? That's a dilemma faced by countless parents in today's world, where technology has given us the ability to see far more deeply and clearly into the human body than medicine ever has before. But all that clarity comes at a cost: High tech scans such as CT – it stands for computedtomography – are not only expensive, but they subject the patient to ionizing radiation. Radiation can increase the rate of certain cancers in the human body. And most at risk – because they are young and still developing and because they can live for many more years, giving cancers time to develop – are children. As parents, it can be difficult
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to weigh the risks and benefits of imaging – and there are no simple answers, says Dr. Alex Schabel, a radiologist with Oregon Imaging Centers in Eugene and Springfield. But physicians have developed guidelines for exposing children to radiation, and you should always ask your doctor to explain the risks and
CT use in young children because of the small risk of cancer over time.” That said, CTs are an extremely useful tool for doctors dealing with certain conditions. There is no other way that is as quick and as sure as a CT scan to diagnose such urgent problems as stroke or head trauma. “S o m e o n e w h o h a s h a d a
benefits of any procedure. “It depends on the age of the child and exactly what we're looking for,” Schabel says. “But we try to optimize
significant head injury, we don't worry about the risk of the scan. One CT scan has a very low and acceptable risk, especially when
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compared to not diagnosing a severe injury or disease,” Schabel says. Schabel's conservative approach is directly in line with national thinking about scans and radiation exposure. According to the National Cancer Institute at the National Institutes of Health, the use of CT scans in both adults and children in the United States has increased eight-fold since 1980, and continues to grow at a rate of 10 percent each year. “CT can be a lifesaving tool for diagnosing illness and injury in children. For an individual child, the risks of CT are small and the individual riskbenefit balance favors the benefit when used appropriately,” the NCI says on its website, cancer.gov. There is no “safe” level of radiation exposure for children, the NCI says, so the use of CT scans will always mean a balancing act between risk and benefit. The NCI recommends, first, using CTs on children only when medically necessary and, second, being sure that exposure is minimized. Children's bodies require less radiation for a scan than continued on page 3… Page 1