Echoing this sentiment is Marta Hernanz-Schulman, radiology vice chair for pediatrics and medical director of diagnostic imaging at Monroe Carell Jr. Children's Hospital at Vanderbilt.

“I agree with the authors that the results need to be interpreted with caution, as this pattern of excess cancer risk may be partly due to confounding by indication,” she said. “I also agree that CT scans are potentially life-saving. We believe in the principle of justification, that scans should be done only when indicated, that the radiation used should be child-sized, and that only the region indicated should be scanned.”


Though an important source of evidence for the impact of radiation dosage from CT, the study is limited by the incidence of brain tumors being higher in the cohort than in the general population, an indication that may partially have influenced the results of the study. In addition, CT is sometimes used to identify conditions associated with an increased tumor risk, which may account for why these children were referred for these exams in the first place.

Scans were collected from Dutch-based radiology departments of hospitals, the only facilities in the Netherlands where pediatric CT exams are performed. All departments were surveyed to determine eligibility and participation.

The study was published in the Journal of the National Cancer Institute.

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