ORIGINAL ARTICLE

Radiation Medicine

, Volume 24, Issue 8, pp 560-567

First online:

Pediatric CT scan usage in Japan: results of a hospital survey

  • Nader GhotbiAffiliated withDepartment of Molecular Medicine, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical SciencesTakashi Nagai Memorial International Hibakusha Medical Center, Nagasaki University Hospital Email author 
  • , Akira OhtsuruAffiliated withTakashi Nagai Memorial International Hibakusha Medical Center, Nagasaki University Hospital
  • , Yoji OgawaAffiliated withDepartment of Radiology, Nagasaki University Hospital
  • , Mariko MorishitaAffiliated withDepartment of Molecular Medicine, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical SciencesTakashi Nagai Memorial International Hibakusha Medical Center, Nagasaki University Hospital
  • , Nana NorimatsuAffiliated withDepartment of Molecular Medicine, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical SciencesDepartment of Pediatrics, Nagasaki University Hospital
  • , Hiroyuki NambaAffiliated withDepartment of Molecular Medicine, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences
  • , Hiroyuki MoriuchiAffiliated withDepartment of Pediatrics, Nagasaki University Hospital
  • , Masataka UetaniAffiliated withDepartment of Radiology, Nagasaki University Hospital
  • , Shunichi YamashitaAffiliated withDepartment of Molecular Medicine, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical SciencesTakashi Nagai Memorial International Hibakusha Medical Center, Nagasaki University HospitalRadiation and Environmental Health, Department of the Protection of Environment, Sustainable Development, and Healthy Environment, WHO/HQ

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Abstract

Purpose

The aim of this study was to examine the usage parameters of diagnostic computed tomography (CT) in children because of concerns of possible overuse in Japanese hospitals, including the “technical” CT exposure settings and the “clinical” grounds for CT requests.

Materials and methods

We examined the methodology at the radiology department to reduce radiation exposure to children and performed a retrospective study on pediatric CT requests during a 1-year period at Nagasaki University Hospital. The parameters of diagnostic CT usage for minor head trauma and acute appendicitis were studied in detail.

Results

CT radiation dose settings are adjusted for children based on guidelines issued by the Japan Radiological Society, with few limitations. CT requests were made for 62% of minor head trauma cases and 76% of cases clinically suspected to be acute appendicitis. These figures are considerably higher than those reported by studies in the United Kingdom, Canada, or the United States. No specific guidelines are advocated regarding CT usage for minor head trauma. The diagnosis of acute appendicitis in children is almost routinely referred for “confirmation” by CT.

Conclusion

CT radiation risks to children at Japanese hospitals need to be considered more seriously. Physicians should be encouraged to follow diagnostic algorithms that help avoid unnecessary CT usage in children.

Key words

Acute appendicitis Computed tomography (CT) Diagnostic radiation dose Minor head trauma Pediatric radiology