Ask the Pediatrician

Concern about radiation exposure prompts FDA to act

A toddler trips up the stairs and is refusing to walk on his left leg.

A fourth grader is beaned in the eye with a baseball during practice.

A 12 year old has weight loss and bad stomach pain.

What these three scenarios have in common is that all of these kids are likely to need some sort of imaging study to figure out what’s wrong. Whether it’s an X-Ray or a CT scan, all of these children will get exposed to some degree of radiation during their assessment. Up until now, manufacturers of X-Ray and CT scanners haven’t been required to have different settings to decrease the amount of radiation children are exposed to. Radiologists have been able to adjust the exposure of the films for these devices and minimize it, but unless the radiologist is trained how to do this and sees children frequently, this often doesn’t happen.

Because the soft tissues and bones are different densities in adults and the radiation needs to travel through more tissue to create the image seen by the technique, the amount of radiation is significantly larger to image an adult compared to a child. Unless your child is being imaged in a children’s hospital, you can’t be sure that these adjustments are made and chances are your child is being exposed to much larger radiation doses than necessary.

The FDA recently has begun to ask manufacturers to have settings designed to dial down the exposure to kids. Radiation exposure is worrisome not only because of its known cancer-causing potential, but because children absorb more radiation than adults and since their bodies are still growing and developing, that risk is compounded.

Parents should question the necessity of any imaging test but especially those tests which have radiation exposure as a part of it. Sometimes the radiation risk is appropriate and figuring out what is wrong is well worth it. Other times, though, non-radiation imaging studies like ultrasound or MRI can be substituted, and occasionally letting more time pass before imaging can be an appropriate strategy.

If your child needs an imaging study, be sure to ask the radiology department if they are adjusting the radiation exposure to reflect the child’s size. If they balk or can’t answer the question, consider going to a children’s hospital to have the test performed.

Dr. Molly O'Shea
Dr. Molly O'Shea is a board-certified pediatrician who cares for families in her practice Birmingham Pediatrics + Wellness Center. She will answer your questions on babies, children, adolescents and families and address common concerns.