September 2 - Imaging Manufacturers Agree to Standardize Pediatric Dose from CT Scans

Representatives from leading medical imaging equipment manufacturers recently met with radiologist, medical physicist, and radiologic technologist representatives from the Alliance for Radiation Safety in Pediatric Imaging, a coalition of 29 organizations dedicated to reducing radiation dose estimates that children receive from medical imaging examinations, and agreed to work with the Alliance to create standardized radiation dose estimates and vendor-sponsored technologist education opportunities.

“This agreement is a fundamental change in responsibility and accountability for the dose estimates that our children—and actually adults, too—receive during CT examinations,” says Donald Frush, MD, chair of the American College of Radiology Pediatric Imaging Commission.

Currently, dose capture and reporting systems can vary depending on the manufacturer, making comparisons difficult. Also, dose estimates for CT scans can underestimate the radiation dose utilized in pediatric imaging because these estimates are often developed using adult phantoms.

“Children are three to five times more sensitive to radiation than adults, yet dose estimates are made using adult-sized phantoms,” says Keith Strauss, MSc, of the American Association of Physicists in Medicine and the director of Radiology Physics and Engineering at Children’s Hospital Boston. “Models need to be developed specifically for estimating dose to children undergoing CT exams utilizing phantoms that more appropriately take into consideration the size, shape, and composition of children’s anatomies.”

Presenters at the meeting included representatives from Alliance organizations as well as from the U.S. Food and Drug Administration and the Medical Imaging and Technology Alliance. Medical imaging vendors represented at the meeting were GE Healthcare, Philips Healthcare, Siemens Medical Systems, and Toshiba America Medical Systems.

“This is an example of how all stakeholders in the medical imaging community can and must work together for the good of our pediatric patients and our profession. This summit and our subsequent agreement to work together, represents a major step forward in ensuring that medical protocols keep pace with rapidly advancing technology and are properly displayed on our CT equipment” says Marilyn Goske, MD, chair of the Alliance for Radiation Safety in Pediatric Imaging, past president of the Society for Pediatric Radiology, and Silverman Chair for Radiology Education at Cincinnati Children's Hospital Medical Center.

Meeting participants produced a list of recommendations for application specialists who train technologists to use CT equipment. They include:
• encourage application specialists to teach the key messages of the Image Gently campaign;
• provide training for all technologists, not just managers;
• provide online materials for technologists who can’t attend in-person training;
• develop uniform language to discuss technological concepts;
• provide listservs or discussion boards for additional help;
• leave behind information about strategies to reduce dose for children;
• involve medical physicists with applications trainers to help with dose reduction techniques; and
• share information about the Image Gently campaign with those whom they train.

“We need to give CT technologists additional training so technologists understand the implication of any changes they make to the scan protocols and how it impacts radiation dose for children” says Greg Morrison, MS, RT(R), CNMT, the executive vice president and chief knowledge officer of the American Society of Radiologic Technologists. “For example, we want technologists to know that the lowest radiation dose is when the patient is perfectly centered within the gantry. These are things we could teach and implement very quickly.”

— Source: American College of Radiology

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