by
John R. Fischer, Senior Reporter | November 23, 2023
They also found similar results earlier this year in another part of their study focused on brain cancer, with the estimated Excess Relative Risk per 100 mGy slightly less, and the expected number of cases per 10,000 children who received a brain CT scan in line with these findings.
Keep dose as low as possible
While Cardis and her colleagues do not suggest changing current dose optimization guidelines, they recommend that dose be “as low as reasonably achievable,” per the ALARA principles; that exams be “justified” to avoid unnecessary overexposure; and that the “benefit-to-risk ratio is maximized for all CT examinations.”
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Pediatric radiologist Dr. David Larson is the professor and executive vice chair in the department of radiology at Stanford University School of Medicine and also the chair of the ACR Commission on Quality and Safety, which oversees the Image Gently Campaign, which performs advocacy work on behalf of improving safe and effective imaging for children.
While not involved with the study, he spoke to HCB News about it, saying that radiologists and technologists need to work with referring clinicians to ensure exams are necessary and that the right protocols are in place, especially for children, and that dose optimization technology is key, as is having a local CT dose management team.
In the future, he expects to see dose optimization become more personalized and precise as new imaging and AI-based technologies receive the green light for use in clinical settings.
“New technologies now hitting the market include photon-counting detector CT and AI-based image reconstruction techniques," he said. "Both have the potential to significantly further reduce dose while maintaining image quality. When combined with local process control programs, there is an opportunity with these technologies to continue to further advance the gains in CT dose reduction achieved since the Image Gently campaign began in 2007."
Cardis and her colleagues are continuing to assess the data from the study to estimate the risk for other types of cancer.
The findings were published in
Nature Medicine.
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