The Alliance for Radiation Safety in Pediatric Imaging recently hosted a pediatric computed tomography (CT) vendor summit to discuss product development to standardize radiation dose estimation settings and display language for pediatric CT scanners. Summit participants also explored how vendor provided education for technologists can promote better understanding of the unique steps required to safely perform CT scans on children. The session was held August 20 at Cincinnati Children's Hospital in Cincinnati.

"Children are not just 'smaller adults.' Their bodies are different and require a different approach to imaging. The purpose of this summit is to work with the vendors to institute a different method to base estimates of radiation dose captured at the time of the CT scan," said Marilyn Goske, M.D., chair of the Alliance for Radiation Safety in Pediatric Imaging, past president of the Society for Pediatric Radiology (SPR), and Silverman Chair for Radiology Education, Cincinnati Children's Hospital Medical Center. "This summit is an example of how all imaging stakeholders can work together to ensure that our youngest patients everywhere receive the safe, effective imaging care that they deserve."

Children are more sensitive to radiation received from imaging scans than adults, and cumulative radiation exposure to their smaller, developing bodies could, over time, have adverse effects. For these reasons, the Alliance, founded by the SPR, the American College of Radiology (ACR), the American Society of Radiologic Technologists (ASRT), and the American Association of Physicists in Medicine (AAPM), launched the Image Gently™ campaign in January 2008 to urge pediatric imaging providers to:

- Significantly reduce, or "child-size," the amount of radiation used

- Not over-scan:
- Scan only when necessary
- Scan only the indicated region
- Scan once; multi-phase scanning (pre- and post-contrast, delayed exams) is rarely helpful

- Be a team player:
- Involve medical physicists to monitor pediatric CT techniques
- Involve technologists to optimize scanning


The Aug. 20 summit was the first formal step in the Image Gently effort to foster increased collaboration between providers and imaging manufacturers to produce scanners with common dose estimation settings and display language. The goal, ultimately, is to enable providers to more consistently perform scans with dose estimates appropriate for children. Providers would also work with vendors to produce educational opportunities which could uniformly instruct technologists how to use the equipment to consistently accommodate the special imaging needs of children.

"Medical imaging stakeholders need to work together to make sure that imaging protocols keep pace with rapidly advancing technology," said Donald P. Frush, M.D., FACR, chair of the ACR Commission on Pediatric Imaging. "This is particularly true regarding the imaging of children. We are proud to reach out to the entire imaging community to raise the quality of care that our youngest patients receive and help ensure that they have ready access to safe, effective imaging care in their own communities."

The summit featured presentations by representatives from the Alliance, including the ACR, SPR, ASRT, and AAPM, as well as the U.S. Food and Drug Administration and the Medical Imaging and Technology Alliance. Representatives from every major medical imaging manufacturer will be in attendance.

"The Alliance's growth shows that people recognize the importance of a team approach to reducing pediatric CT dose," said Greg Morrison, RT(R), CNMT, CAE, ASRT Executive Vice President and Chief Knowledge Officer. "Thanks to the Image Gently campaign, children who undergo a CT scan have a community of physicists, radiologists, radiologic technologists and vendors protecting them and pledging to keep them safe."

Since the Image Gently campaign launch in January 2008, the Alliance has grown to include 26 organizations. More than 1,400 imaging providers representing more than 1,000 facilities have taken the Image Gently pledge to reduce the radiation dose used in the performance of pediatric CT scans. The campaign has been honored by a resolution in the U.S. House of Representatives and nominated for a National Quality Forum award.

"We now have tools available to us that allow the improvement of the estimation of patient dose. This summit provides us with the opportunity to begin dialogue with the equipment vendors on how to harness these tools to improve patient care," said Keith Strauss, M.S., FACR, chair of the AAPM Image Gently Subcommittee.

The Image Gently Web site (www.imagegently.org) contains the latest research and educational materials to aid radiologists, radiologic technologists, medical physicists, and other imaging stakeholders in determining the appropriate radiation techniques to be used in the imaging of children and how the radiation received from these exams may affect pediatric patients over time.

A key feature of the new Web site is a library of helpful protocols that can be used for the imaging of children. Radiologists and other imaging providers are urged to visit the Image Gently Web site (www.imagegently.org) and pledge to do their part to "child-size" the radiation dose used in children's imaging.