When you're in the emergency room or a doctor's office and the medical staff recommends imaging, it's important to keep this in mind: Some forms of imaging are much safer than others.
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X-rays are high-energy studies that use ionizing radiation, meaning the energy is strong enough to knock an electron out of an atom. Fortunately, the dose of ionizing radiation from a basic chest X-ray (CXR) or bone X-ray is relatively low. For example, when a CXR is performed, a patient receives a dose of radiation equivalent to outdoor exposure for about a week.
On the other hand, CT scans, or CT scans, are high-radiation studies, and the exact dose depends on the type of exam being performed. To give you an idea, the radiation dose from a head CT scan is equivalent to about 200 chest X-rays, while an abdominal CT scan is equivalent to nearly 600 CXRs!
Why is ionizing radiation problematic?
Exposure to ionizing radiation increases the risk of developing cancer later in life, with the risk being dose-dependent. Since the widespread introduction of brain computed tomography in the 1980s, brain tumor rates have increased dramatically, an unfortunately causal relationship.
The less radiation the better, especially for children
When it comes to radiation exposure, less is more, especially for children . Because their bodies and brains are still developing, children are more sensitive to radiation than adults. In addition, because they live longer, they have an increased potential to accumulate a significant cumulative dose of radiation over time.
A single head CT scan may not be a major problem, but the total radiation dose adds up quickly if scans are repeated. That’s why the pediatric pendulum has swung toward using non-radiation tests, such as ultrasound and MRI, whenever possible. If an emergency room doctor indicates that your child needs a CT scan, don’t hesitate to ask if an ultrasound or MRI could be done instead. Fortunately, in many pediatric emergency departments, rapid MRI is replacing CT scans for brain imaging.
High-risk radiological studies to avoid
In addition to abdominal and brain CT scans, other pediatric imaging tests can also increase the risk of cancer in the future. Here are some common and problematic imaging tests:
- CT scan of the neck : Sometimes used to rule out deep tissue infection, this study should be avoided because the thyroid gland, located in the center of the neck, is extremely sensitive to radiation.
- Voiding cystoscopies (VCUG) : Performed to assess urinary reflux, the radiation dose from a VCUG is approximately 3 millisieverts (mSv), the equivalent of 300 chest X-rays.
- Upper gastrointestinal series : Requested to examine intestinal anatomy in children with refractory vomiting, this test may be unavoidable, but the radiation dose is high at 6 mSv, equivalent to an abdominal CT scan or 600 chest X-rays.
In general, the radiation dose incurred during any fluoroscopic study (which assesses tissue movement in real time) can be quite high.
For more information on radiation risks and preferred alternatives, see this article on radiation protection .
