Pediatric Scanning; Is It Necessary for My Child?

04/20/2018

Diagnostic medical imaging is extremely valuable for assessing the pediatric population. Specific imaging modalities can be particularly helpful for doctors by providing information needed to make accurate assessments, leading to an appropriate and timely treatment plan. However, working with infants, children, and adolescents creates several unique challenges, including resistance from parents to altered medical procedures and techniques for healthcare workers. The purpose of this article is to provide clarity about pediatric diagnostic imaging, so you can be confident your child’s exam is necessary and the medical benefits outweigh any potential risks involved.

Children are different from adults in several ways; from a granular perspective, maturity and independence have a large impact on behavior. From a more simplistic perspective, a child’s physiology is completely different than an adults’. As stated by the World Health Organization, “Children are not just little adults.” Therefore, the distinct challenges accompanied with pediatric imaging must be addressed by healthcare providers.

Arguably the biggest challenge for doctors and technicians attempting to capture high quality images from a child is gaining their complete trust, which results in their cooperation during the exam. This can be tough when a child is placed in an intimidating and unfamiliar environment such as an MRI machine. It can be incredibly difficult for a child to remain still in the loud machine for the duration of the exam (often 30 minutes or longer). If a child cannot remain still for the exam, a slight immobilizer might be needed. However, support from parents and family can help in comforting a child, and most providers prefer not to rely on sedatives for an exam.

Another factor that must be taken into consideration is the basic physiology of the patient. A 6-year-old girl will have drastically different organ development compared to a 45-year-old man. As such, adjustments must be made on the providers end. Any exam that emits radiation should only be performed when the healthcare provider believes it is necessary to answer a clinical question or to help with treatment.  Additionally, FDA recommends X-ray imaging exams are optimized for the lowest possible radiation dose (As low as reasonably achievable – the ALARA principle).

Numerous factors influence the amount of radiation needed, but a patient’s size and tissue density are the most important factors when determining the dose. Age gives imaging providers a benchmark to start with, but the actual distance the X-ray travels through the body has the largest impact on picture quality.

Unnecessary radiation exposure should be avoided at a young age, however, X-rays, CT scans, and other diagnostic imaging tests should never be withheld from a child or adolescent if the results could aid in the diagnosis or treatment of a serious medical condition.

It is important to note that healthcare providers are responsible for ensuring all diagnostic exams are justifiable for pediatrics. If there is another option to reach the same conclusions without radiation exposure, such as an ultrasound or MRI, it will be strongly considered. Ultrasound is particularly useful because it is readily available and does not involve ionized radiation. Furthermore, ultrasound exams can be repeated for follow up studies with no significant risks and no concerns for additional exposure.

At Insight Medical Imaging we encourage parents to talk to their healthcare provider before undertaking an exam with radiation exposure. Talk about the benefits, risks, and ask if there are any other exams, such as ultrasound that can provide similar findings. You can also talk to your physician about different imaging facilities, how they use radiation techniques for children, and if any special preparation is required.

Diagnostic medical imaging exams such as X-ray, ultrasound, or MRI can be intimidating for both parents and children. Although you may be concerned about radiation exposure, your medical practitioner will only recommend an exam when the benefits far outweigh the associated risks. X-ray exams are commonly used, and while radiation exposure might seem frightening, you would need to be exposed to a large quantity of X-rays in a relatively short period of time before you should be concerned about impacts on your health. Just remember, the radiation exposure you receive from being in the sun on average in a year is equivalent to roughly 60 chest X-rays!