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Justifying referrals for paediatric CT

Zoe Brady, Timothy M Cain and Peter N Johnston
Med J Aust 2012; 197 (2): 95-99. || doi: 10.5694/mja11.11124
  • Zoe Brady1,2,0
  • Timothy M Cain3
  • Peter N Johnston2,4,0

  • 1 Radiology, Alfred Health, Melbourne, VIC.
  • 2 Applied Physics, RMIT University, Melbourne, VIC.
  • 3 Medical Imaging, The Royal Children’s Hospital Melbourne, Melbourne, VIC.
  • 4 Medical Radiation Services Branch, Australian Radiation Protection and Nuclear Safety Agency, Melbourne, VIC.

Correspondence: z.brady@alfred.org.au

Competing interests:

No relevant disclosures.

  • 1. Royal Australian and New Zealand College of Radiologists. Computed Tomography and Radiation Risks. Position statement. Sydney: RANZCR, 2010. http://www.ranzcr.edu.au/resources/professional-documents/position-statements (accessed Jun 2012).
  • 2. de Gelder R, Draisma G, Heijnsdijk EA, de Koning HJ. Population-based mammography screening below age 50: balancing radiation-induced vs prevented breast cancer deaths. Br J Cancer 2011; 104: 1214-1220.
  • 3. Yaffe MJ, Mainprize JG. Risk of radiation-induced breast cancer from mammographic screening. Radiology 2011; 258: 98-105.
  • 4. Brenner DJ, Elliston CD. Estimated radiation risks potentially associated with full-body CT screening. Radiology 2004; 232: 735-738.
  • 5. Royal Australian and New Zealand College of Radiologists. The use of diagnostic imaging for screening purposes and non-referred investigations. Statement of principles. Sydney: RANZCR, 2005. http://www.ranzcr.edu.au/resources/professional-documents/policies (accessed Jun 2012).
  • 6. Blecher CM. Alarm about computed tomography scans is unjustified [letter]. Med J Aust 2010; 192: 723-734. <MJA full text>
  • 7. Mendelson RM, Fox RA, de Klerk NH. Alarm about computed tomography scans is unjustified [letter]. Med J Aust 2010; 193: 246. <MJA full text>
  • 8. Heggie JC, Goergen SK, Fallon MJ. Alarm about computed tomography scans is unjustified [letter]. Med J Aust 2011; 194: 150-151. <MJA full text>
  • 9. International Commission on Radiological Protection. The 2007 recommendations of the International Commission on Radiological Protection. ICRP Publication 103. Ann ICRP 2007; 37: 1-332.
  • 10. International Commission on Radiological Protection. Low-dose extrapolation of radiation-related cancer risk. ICRP Publication 99. Ann ICRP 2005; 35: 1-140.
  • 11. National Research Council. Health risks from exposure to low levels of ionizing radiation: BEIR VII Phase 2. Washington, DC: The National Academies Press, 2006. http://www.nap.edu/catalog.php?record_id=11340 (accessed Jun 2012).
  • 12. de Campo JF, de Campo MP. Is informed consent necessary for computed tomography in children and young adults? [letter]. Med J Aust 2010; 192: 423. <MJA full text>
  • 13. Preston DL, Shimizu Y, Pierce DA, et al. Studies of mortality of atomic bomb survivors. Report 13: Solid cancer and noncancer disease mortality: 1950-1997. Radiat Res 2003; 160: 381-407.
  • 14. Brenner DJ, Doll R, Goodhead DT, et al. Cancer risks attributable to low doses of ionizing radiation: assessing what we really know. Proc Natl Acad Sci U S A 2003; 100: 13761-13766.
  • 15. United Nations Scientific Committee on the Effects of Atomic Radiation. Sources and effects of ionizing radiation. Vol I: Sources. Vol II: Effects. UNSCEAR 2000 Report to the General Assembly, with scientific annexes. New York: United Nations, 2000. http://www.unscear.org/unscear/en/publications.html (accessed Jun 2012).
  • 16. Tubiana M, Feinendegen LE, Yang C, Kaminski JM. The linear no-threshold relationship is inconsistent with radiation biologic and experimental data. Radiology 2009; 251: 13-22.
  • 17. Sykes PJ, Day TK. Requirements for identification of low dose and non-linear mutagenic responses to ionising radiation. Dose Response 2007; 5: 308-314.
  • 18. Nair RR, Rajan B, Akiba S, et al. Background radiation and cancer incidence in Kerala, India — Karanagappally cohort study. Health Phys 2009; 96: 55-66.
  • 19. Pearce MS, Salotti JA, Little MP, et al. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet 2012; 7 Jun. [Epub ahead of print.] doi: 10.1016/S0140-6736(12)60815-0.
  • 20. Shuryak I, Sachs RK, Brenner DJ. Cancer risks after radiation exposure in middle age. J Natl Cancer Inst 2010; 102: 1628-1636.
  • 21. Picano E. Informed consent and communication of risk from radiological and nuclear medicine examinations: how to escape from a communication inferno. BMJ 2004; 329: 849-851.
  • 22. United Nations Scientific Committee on the Effects of Atomic Radiation. Sources and effects of ionizing radiation. Vol I. UNSCEAR 2008 Report to the UN General Assembly. Annex A: Medical Radiation Exposures. New York: United Nations, 2010. http://www.unscear.org/unscear/en/publications.html (accessed Jun 2012).
  • 23. Brady Z, Cain TM, Johnston PN. Paediatric CT imaging trends in Australia. J Med Imaging Radiat Oncol 2011; 55: 132-142.
  • 24. Paterson A, Frush DP, Donnelly LF. Helical CT of the body: are settings adjusted for pediatric patients? AJR Am J Roentgenol 2001; 176: 297-301.
  • 25. Brenner D, Elliston C, Hall E, Berdon W. Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR Am J Roentgenol 2001; 176: 289-296.
  • 26. Donnelly LF, Emery KH, Brody AS, et al. Minimizing radiation dose for pediatric body applications of single-detector helical CT: strategies at a large Children’s Hospital. AJR Am J Roentgenol 2001; 176: 303-306.
  • 27. Goske MJ, Applegate KE, Boylan J, et al. The Image Gently campaign: working together to change practice. AJR Am J Roentgenol 2008; 190: 273-274.
  • 28. Image Gently. The Alliance for Radiation Safety in Pediatric Imaging. http://www.pedrad.org/associations/5364/ig/ (accessed Jun 2012).
  • 29. International Commission on Radiological Protection. Radiation protection in medicine. ICRP Publication 105. Ann ICRP 2007; 37: 1-63.
  • 30. Donnelly LF. Reducing radiation dose associated with pediatric CT by decreasing unnecessary examinations. AJR Am J Roentgenol 2005; 184: 655-657.
  • 31. Hendee WR, Becker GJ, Borgstede JP, et al. Addressing overutilization in medical imaging. Radiology 2010; 257: 240-245.
  • 32. Professional Services Review. PSR report to the professions 2008-09. Canberra: Commonwealth of Australia, 2010. http://www.psr.gov.au/publications-and-resources/other-publications (accessed Jun 2012).
  • 33. Goske MJ, Bulas D. Improving health literacy: informed decision-making rather than informed consent for CT scans in children. Pediatr Radiol 2009; 39: 901-903.
  • 34. Karsli T, Kalra MK, Self JL, et al. What physicians think about the need for informed consent for communicating the risk of cancer from low-dose radiation. Pediatr Radiol 2009; 39: 917-925.
  • 35. Larson DB, Rader SB, Forman HP, Fenton LZ. Informing parents about CT radiation exposure in children: it’s OK to tell them. AJR Am J Roentgenol 2007; 189: 271-275.

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