Stories about: radiation

Reducing radiation exposure in kids with kidney stones

A kidney stone seen on CT (James Heilman/Wikimedia Commons)
A kidney stone seen on CT (James Heilman/Wikimedia Commons)
Two national trends have preoccupied Caleb Nelson, MD, MPH, and his colleagues in the Boston Children’s Hospital’s Urology Department over the past few years. One is the rise in overall exposure to medical radiation. The second is specifically the increased use of computed tomography (CT) scans—rather than clinician-preferred ultrasound—in children with kidney stones.

“We see a lot of kids with stones, and there is a clinical need to better manage their condition,” Nelson explains. “Medical radiation is a risk factor for problems down the road, and we know that the amount of radiation people are receiving has gone through the roof in recent years.”

How big is the problem? Nelson cites data collected on radiation exposure on the U.S. population from 1987 to 2006 by the National Council on Radiation Protection and Measurements (NCRP). At the beginning of the study, about 18 percent of all radiation exposure was medical. By 2006, that number had grown to 48 percent (see chart below).

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The power of numbers: Rules for reining in the use of CT scans

When does a trauma patient need a CT scan? Clinical rules could help doctors decide, and in the process help reduce a child's lifetime radiation exposure. (Image: Andrew Ciscel/Flickr)

The use of computed tomography (CT) scans has dramatically changed the practice of medicine in the past two decades. Patients with abdominal pain are no longer routinely admitted for serial abdominal exams to evaluate for appendicitis, because now we can just get the CT. Children with head trauma may need less hospital observation time in the emergency department (ED), because we can just get the CT.

But “just getting the CT” comes with costs, not just medical healthcare dollars spent but the costs associated with lethal malignancies in the future caused by the radiation used in the course of CTs.

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