Children’s hospitals are using CT scans significantly less to diagnose common childhood ailments including seizure, concussion, appendectomy and upper respiratory tract infection, according to a new Cincinnati Children’s study. The results were published in the journal Pediatrics.

The researchers assume that the decline in CT usage is due to increasing evidence that the ionizing radiation from CT scans is associated with an increased risk of cancer in patients. Exposing 10,000 children to the ionizing radiation may lead to one malignancy, according to previous published research.

Instead, the children’s hospitals are opting to use alternative imaging that doesn’t involve radiation, including ultrasound and MRI. However, there may still be a need for CT in cases where ultrasound and MRI aren’t adequate.
The study was conducted using the Children’s Hospital Association’s Pediatric Health Information System, which is a comparative pediatric database that provides information on clinical and resource utilization on inpatient, ambulatory surgery emergency department and observation unit patients at 45 children’s hospitals.

The researchers evaluated inpatient and observation unit patients for 10 specific diagnoses at 33 participating hospitals from January 1, 2004 to December 31, 2012. The diagnoses analyzed were seizure, ventricular shunt procedure, craniotomy, concussion, severe head trauma, appendectomy, gastroenteritis, abdominal pain, upper respiratory tract infection and ENT conditions.

In an article published in June, HCB News reported that Vanderbilt Children’s Hospital had a 45 percent decline in the number of CT studies from 2006 to 2015 even though an increasing number of children visited their emergency department. A professor at the hospital credits the trend toward lower utilization and initiatives such as Image Gently, Image Wisely, and ACR appropriateness criteria.

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