“Image Gently” Project Seeks to Limit Unnecessary Imaging and Radiation Levels in Children

Newswise — The Society for Pediatric Radiology, which includes physicians from Memorial Sloan-Kettering Cancer Center (MSKCC), has launched a project known as Image Gently, which seeks to decrease unnecessary imaging and radiation levels in children. The American College of Radiology estimates that there are seven million computed tomography (CT) scans performed in children each year in the US, a number that is increasing about 10 percent annually.

While CT is a useful imaging tool that produces quality diagnostic images of underlying conditions, CT scans expose patients to significantly more radiation than standard x-rays. This is an issue of particular importance for children, whose tissues are more sensitive to the larger relative radiation doses they receive, and who have a longer period of time to develop cancers that may result from the radiation exposure.

Sara J. Abramson, Director of Pediatric Radiology at MSKCC and a member of the Image Gently project, points out that the lifetime accumulated effects of radiation may be a concern, especially for children who have been treated for cancer. As a result, she notes, the pediatric radiologists at MSKCC must approve every CT scan that a physician orders before it is performed on a child.

"That these are children with cancer does not negate the fact that they need to be handled with care," she says. "In fact, it increases the need for oversight by the pediatric radiologist."

For more than ten years, radiologists and technicians at MSKCC have followed the ALARA (As Low As Reasonably Achievable) standard operating principle, using equipment and software that lower the radiation exposure in children by setting the radiation parameters based on the size of the child.

A much-debated review article in the November 29, 2007, issue of The New England Journal of Medicine suggests that more frequent use of CT scanning may increase a person's lifetime risk of developing cancer. However, experts note that this risk may be outweighed by a CT scan's ability to diagnose an illness that potentially could be missed by other imaging tools.

The Image Gently project states that, as with any medical test, the beneficial information gained from a CT scan should outweigh the risks generated by having the test performed.

"We believe this project can help decrease unnecessary imaging and also unnecessary radiation exposure in the pediatric population, not only by giving specific parameters for the actual imaging but also by providing guidelines for determining what constitutes necessary imaging," says Dr. Abramson. "This will help radiologists in academic centers, private practices, and local hospitals. It is also meant to inform emergency room physicians and pediatricians about the need to think before ordering CT for children " and to image 'gently' when they do."

The members of the Image Gently project recommend that parents ask if an imaging facility has American College of Radiology (ACR) accreditation. The MSKCC radiology department is ACR accredited. The project also provides medical professionals with specific parameters and suggested techniques that can be used to dramatically decrease the amount of radiation children are exposed to during CT.

Memorial Sloan-Kettering Cancer Center is the world's oldest and largest private institution devoted to prevention, patient care, research, and education in cancer. Our scientists and clinicians generate innovative approaches to better understand, diagnose, and treat cancer. Our specialists are leaders in biomedical research and in translating the latest research to advance the standard of cancer care worldwide. For more information, go to http://www.mskcc.org.