Skip to main content

Advertisement

SpringerLink
Log in

CT scans in young people in Northern England: trends and patterns 1993–2002

  • Original Article
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Background

Although CT can be greatly beneficial, its relatively high radiation doses have caused public health concerns.

Objective

To assess patterns in CT usage among patients aged less than 22 years in Northern England during the period 1993–2002.

Materials and methods

Electronic data were obtained from radiology information systems of all nine National Health Service trusts in the region.

Results

A total of 38,681 scans had been performed in 20,483 patients aged less than 22 years. The number of CT examinations rose, with the steepest increase between 1997 and 2000. The number of patients scanned per year increased less dramatically, with 2.24/1,000 population aged less than 22 years having one scan or more in 1993 compared to 3.54/1,000 in 2002. This reflects an increase in the median number of scans per patient, which rose from 1 in 1993 to 2 by 1999. More than 70% of CT examinations were of the head, with the number of head examinations varying with time and patient age.

Conclusion

The frequency of CT scans in this population more than doubled during the study period. This is partly, but not wholly, explained by an increase in the number of scans per patient.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Hart D, Wall BF (2004) UK population dose from medical X-ray examinations. Eur J Radiol 50:285–291

    Article  PubMed  CAS  Google Scholar 

  2. Department of Health. Hospital Activity Statistics (2008) Available from: http://www.performance.doh.gov.uk/hospitalactivity/data_requests/imaging_and_radiodiagnostics.htm. Accessed May 2011

  3. Rehani MM, Berry M (2000) Radiation doses in computed tomography. The increasing doses of radiation need to be controlled. Br Med J 320:593–594

    Article  CAS  Google Scholar 

  4. Brenner DJ, Elliston CD, Hall EJ et al (2001) Estimated risks of radiation-induced fatal cancer from paediatric CT. AJR 176:289–296

    PubMed  CAS  Google Scholar 

  5. Parker L (2001) Computed tomography scanning in children: radiation risks. Pediatr Hematol Oncol 18:307–308

    Article  PubMed  CAS  Google Scholar 

  6. Paterson A, Frush DP, Donnelly LF (2001) Helical CT of the body: are settings adjusted for paediatric patients? AJR 176:297–301

    PubMed  CAS  Google Scholar 

  7. Brenner DJ, Elliston CD (2004) Estimated radiation risks potentially associated with full-body screening. Radiology 232:735–738

    Article  PubMed  Google Scholar 

  8. Brenner DJ, Hall EJ (2007) Computed tomography–an increasing source of radiation exposure. N Engl J Med 357:2277–2284

    Article  PubMed  CAS  Google Scholar 

  9. Chodick G, Ronckers CM, Shalev V et al (2007) Excess lifetime cancer mortality risk attributable to radiation exposure from computed tomography examinations in children. IMAJ 9:584–587

    PubMed  Google Scholar 

  10. Berrington de González A, Mahesh M, Kim KP et al (2009) Projected cancer risks from computed tomographic scans performed in the United States in 2007. Arch Int Med 169:2071–2077

    Article  Google Scholar 

  11. Sodickson A, Baeyens PF, Andriole KP et al (2009) Recurrent CT, cumulative radiation exposure, and associated radiation-induced cancer risks from CT of adults. Radiology 251:175–184

    Article  PubMed  Google Scholar 

  12. Voss SD, Reaman GH, Kaste SC et al (2009) The ALARA concept in pediatric oncology. Pediatr Radiol 39:1142–1146

    Article  PubMed  Google Scholar 

  13. Mettler FA, Wiest PW, Locken JA et al (2000) CT scanning: patterns of use and dose. J Radiol Prot 20:353–359

    Article  PubMed  Google Scholar 

  14. Shrimpton PC, Jones DG, Hillier MC et al (1991) Survey of CT practice in the UK: Part 2. Dosimetric Aspects. Chilton: NRPB-R249. HMSO, London

    Google Scholar 

  15. Chodick G, Ronckers CM, Ron E et al (2006) The utilization of paediatric computed tomography in a large Israeli HMO. Pediatr Radiol 36:485–490

    Article  PubMed  Google Scholar 

  16. Mettler FA, Thomadsen BR, Bhargavan M et al (2008) Medical radiation exposure in the U.S. in 2006: Preliminary results. Health Phys 95:502–507

    Article  PubMed  CAS  Google Scholar 

  17. Hall EJ, Brenner DJ (2008) Cancer risks from diagnostic radiology. Br J Radiol 81:362–378

    Article  PubMed  CAS  Google Scholar 

  18. Boone JM, Brunberg JA (2008) Computed tomography in a tertiary care university hospital. J Am Coll Radiol 132–138

  19. Markel TA, Kumar R, Koontz NA et al (2009) The utility of computed tomography as a screening tool for the evaluation of pediatric blunt chest trauma. J Trauma 67:23–28

    Article  PubMed  Google Scholar 

  20. Bartlett J, Kett-White R, Mendelow AD et al (1998) Recommendations from the Society of British Neurological Surgeons. Br J Neurosurg 12:349–352

    Article  PubMed  CAS  Google Scholar 

  21. Royal College of Radiologists (1998) Making the best use of a department of clinical radiology: guidelines for doctors, 4th edn. The College, London

    Google Scholar 

  22. Royal College of Surgeons England (1999) Report of the working party on the management of patients with head injuries. London http://www.rcseng.ac.uk/publications/docs/report_head_injuries.html. Accessed May 2011

  23. Mettler FA, Bhargavan M, Faulkner K et al (2009) Radiologic and nuclear medicine studies in the United States and Worldwide: Frequency, radiation dose, and comparison with other radiation sources, 1950–2007. Radiology 253:520–531

    Article  PubMed  Google Scholar 

  24. Galanski M, Nagel HD, Stamm G (2006) Pediatric CT exposure practice in the federal republic of Germany. Results of a nationwide survey in 2005/06. Medizinische Hochschule, Hannover

    Google Scholar 

  25. Clarke JC, Cranley K, Kelly BE et al (2001) Provision of MRI can significantly reduce CT collective dose. Br J Radiol 74:926–931

    PubMed  CAS  Google Scholar 

  26. Ghotbi N, Ohtsuru A, Ogawa Y et al (2006) Pediatric CT scan usage in Japan: results of a hospital survey. Radiat Med 24:560–567

    Article  PubMed  Google Scholar 

  27. Mazrani W, McHugh K, Marsden PJ (2007) The radiation burden of radiological investigations. Arch Dis Child 92:1127–1131

    Article  PubMed  CAS  Google Scholar 

  28. Oikarinen H, Meriläinen S, Pääkkö E et al (2009) Unjustified CT examinations in young patients. Eur Radiol 19:1161–1165

    Article  PubMed  Google Scholar 

  29. Ruess L, Sivit CJ, Eichelberger MR et al (1997) Blunt abdominal trauma in children: impact of CT on operative and nonoperative management. AJR 169:1011–1014

    PubMed  CAS  Google Scholar 

  30. Renton J, Kincaid S, Ehrlich PF (2003) Should helical CT scanning of the thoracic cavity replace the conventional chest X-ray as a primary assessment tool in pediatric trauma? An efficacy and cost analysis. J Pediatr Surg 38:793–797

    Article  PubMed  CAS  Google Scholar 

  31. Durham SR, Liu KC, Selden NR (2006) Utility of serial computed tomography in pediatric patients with head trauma. J Neurosurg 105:365–369

    PubMed  Google Scholar 

  32. Maytal J, Krauss JM, Novak G et al (2000) The role of brain computed tomography in evaluating children with new onset of seizures in the emergency department. Epilepsia 41:950–954

    Article  PubMed  CAS  Google Scholar 

  33. Donmez FY, Guvenc Z, Emiroglu FK et al (2009) Evaluation of neurological complications in pediatric liver transplant recipients: MRI versus CT. J Child Neurol 24:656–663

    Article  PubMed  Google Scholar 

  34. Lewis DW, Dorbad D (2000) The utility of neuroimaging in the evaluation of children with migraine or chronic daily headache who have normal neurological examinations. Headache 40:629–632

    Article  PubMed  CAS  Google Scholar 

  35. Frush DP, Frush KS, Oldham KT (2009) Imaging of acute appendicitis in children: EU versus U.S. … or US versus CT? A North American perspective. Pediatr Radiol 39:500–505

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This study was supported by contract NO2-CP-75501 from the United States National Cancer Institute and through funding from the Radiation Research Programme of the United Kingdom Department of Health. We thank the staff in radiology departments across the Northern Region of England who contributed data to this study and Mrs. Katharine Kirton and Mr. Richard Hardy for their assistance with the study. We also thank Dr. John Kotre for his comments on the paper.

Author information

Authors and Affiliations

  1. Institute of Health and Society, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK

    Mark S. Pearce, Jane A. Salotti & Wenhua Metcalf

  2. Great Ormond Street Hospital for Children NHS Trust, London, UK

    Kieran McHugh

  3. Department of Nuclear Engineering, Kyung Hee University, Gyeongi-Do, Republic of Korea

    Kwang P. Kim

  4. Northern Institute of Cancer Research, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle University, Newcastle upon Tyne, UK

    Alan W. Craft

  5. Departments of Medicine and Paediatrics, Population Cancer Research Program, Dalhousie University and Cancer Care Nova Scotia, Halifax, NS, Canada

    Louise Parker

  6. Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA

    Elaine Ron

Authors
  1. Mark S. Pearce
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jane A. Salotti
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kieran McHugh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wenhua Metcalf
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kwang P. Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Alan W. Craft
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Louise Parker
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Elaine Ron
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mark S. Pearce.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pearce, M.S., Salotti, J.A., McHugh, K. et al. CT scans in young people in Northern England: trends and patterns 1993–2002. Pediatr Radiol 41, 832–838 (2011). https://doi.org/10.1007/s00247-011-2110-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-011-2110-7

Keywords

Search

Navigation