11/02/2018: Physician Knowledge of Radiation Exposure and Risk in Medical Imaging
10/31/2018: Children With Mild Head Injuries Are Still Getting Too Many Brain Scans - Forbes
10/26/2018: The Butterfly Effect - Image Gently's Newsletter, October 2018
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2017 Butterfly Award
Dr. S. Ted Treves and Dr. Fred Fahey accepted the 2017 Butterfly Award on behalf of the Image Gently Nuclear Medicine Working Group at the 2017 Image Gently Alliance Meeting in Chicago, Illinois on November 27, 2017.
To see previous Butterfly Awards....
By: Jason B. Hobbs, MD, Noah Goldstein, BS, Kimberly E. Lind, PhD, MPH, Deirdre Elder, MS, Gerald D. Dodd III, MD, James P. Borgstede, MD
Medical imaging is an increasingly important source of radiation exposure for the general population, and there are risks associated with such exposure; however, recent studies have demonstrated poor understanding of medical radiation among various groups of health care providers. This study had two aims: (1) analyze physicians’ knowledge of radiation exposure and risk in diagnostic imaging across multiple specialties and levels of training, and (2) assess the effectiveness of a brief educational presentation on improving physicians’ knowledge.
One of the worst fears parents have is getting a call from school, from a coach, from highway patrol, or even witnessing themselves that their child suffered a head injury. While more protective headgear during sports and child safety seats in cars has resulted in a decrease in the numbers of severe head injuries on playing fields and in motor vehicle accidents, head injuries in children continue to be a concern, not only in frequency, but in how to manage them. Traumatic Brain Injury (TBI) has become increasingly recognized in children, specifically regarding the need for better monitoring following concussions. A large portion of children with mild head injuries are seen by their primary care doctors, avoiding unnecessary visits to emergency rooms. However, TBI continues to be an issue, and its management has more recently become an area of study. A recent article looked at data from the National Hospital Ambulatory Care Medical Survey databases from 2007-2015, obtaining a representative sample of children under age 18 years visiting emergency departments for head injuries. Of the 14.3 million children studied, 32% underwent CT (computed tomography) scans of the brain if being evaluated for a head injury. These included those with injuries ranging from minor, without loss of consciousness, to major, with severe neurologic damage. There have been many initiatives over the past decade in providing better guidelines to tailor needs of children based on severity of injury, as the vast majority of children with minor or moderate TBI, even with signs of concussion, do not need CT scans. Despite many educational efforts, the 32% rate of CT scans for pediatric head injuries did not decline during the nine-year study period.
Dr. Christopher Giza, director of the UCLA Steve Tisch BrainSPORT Program, has several potential explanations
Pediatric radiation safety guidelines are written at far too difficult reading levels for the average parent to understand, according to a study recently published in the American Journal of Roentgenology.
Researchers from the Johns Hopkins Hospital assessed 54 articles on patient safety that were published on websites such as the Society for Pediatric Radiology, RadiologyInfo, and the American Academy of Pediatrics. Using the ANOVA (Analysis of Variance) scale, they found
Image Wisely has redesigned their website! Please take a couple of minutes to visit and flip through the pages.
David J.Mulvihill, MD; Sachin Jhawar, MD; John B.Kostis, MD; SharadGoyal, MD
Environmental factors have long been thought to play a role in the development of adult and pediatric malignancies. Studies involving long-term survivors of the atomic bombing of Hiroshima and Nagasaki as well as studies involving nuclear and radiation workers have provided compelling evidence correlating ionizing radiation with carcinogenesis 1, 2. Furthermore, it is estimated that only 5% of pediatric cancers are directly attributable to an inherited genetic cause (3), and ionizing radiation has been shown to be causal in a large number of human malignancies (4). At times veiled within the context of health-care delivery, exposure to ionizing radiation from diagnostic medical imaging is increasing in the United States. In a report by the National Council on Radiation Protection and Measurements in 2009, it was stated that “in 2006 Americans were exposed to more than seven times as much ionizing radiation from medical procedures as was the case in the early 1980s” (5). The pediatric population is certainly not immune to the rising radiation exposure from medical imaging. For example, the increased use of computed tomography (CT) scanners in the diagnosis of pediatric conditions has grown steadily over the past decade (6), and according to some publications
Kushaljit S.Sodhi, SatheeshKrishna, Akshay K.Saxena, AninditaSinha, NiranjanKhandelwal, Edward Y.Lee
Received 10 April 2015, Revised 22 May 2015, Accepted 26 May 2015, Available online 27 May 2015.
• Practice of ALARA (As Low As Reasonably Achievable) principle in the developed world is currently well established. However, there is striking lack of published data regarding such experience in the developing countries. Therefore, the goal of this study is to prospectively evaluate CT request forms to assess how many children could be saved from harmful radiation exposure if ‘Justification’ and ‘Optimization’ principles of ALARA are applied before obtaining CT imaging in a developing country.
• A consecutive 1302 CT request forms over a six month study period (May 16, 2013 to November 15, 2013) in a tertiary pediatric children’s hospital in India were prospectively reviewed by two pediatric radiologists before obtaining CT imaging. First, ‘Justification’ of CT was evaluated and then ‘Optimization’ was applied for evaluation of appropriateness of the requested CT studies. The number (and percentage) of CT studies that was avoided by applying ‘Justification’ and ‘Optimization’ principle of ALARA were calculated. The difference in number of declined and optimized CT requests between CT requests from inpatient and outpatient departments was compared using Chi-Square test.
By: Sotiria Triantopoulou an dVerginia Tsapaki
• The diseases associated with multiple CT examinations in children are identified.
• Children with malignancy are exposed to high radiation doses from CT examinations.
• Children with malignancies have an increased risk for radiation-induced cancer.
• The necessity of minimizing the CT radiation dose of these patients is emphasized.
The purpose of this study was to identify the main pathologies for which CT is applied on pediatric patients and the related radiation doses as reported in the literature in order to facilitate justification and CT optimization.
A critical analysis of a literature review was performed. Different
A children’s book entitled, Learning about X-rays with Lula and Ethan is based on one young child, Ethan, getting a head CT after having a minor playground injury. Read more here....