Chicago Tribune reports on concerns about kids' CT scans

An important story, well told by the Tribune and veteran writer Judith Graham. Excerpts:

“Families have reason to be alert to risks associated with diagnostic tests such as CT scans. Kids’ changing bodies and brains are especially sensitive to ionizing radiation from X-rays used in the exams. And because children have longer to live than adults, they’re more likely to experience delayed effects of radiation exposure, notably a small potential increased risk of cancer.

That’s not a cause to shun the tests, medical experts agree. Medical imaging is an extraordinary tool that allows doctors to make diagnoses, select optimal treatments and save lives, they say.

But it does warrant caution, and medical professionals have been adopting measures to reduce children’s radiation exposure. These include adjusting CT scanner settings for smaller bodies, imaging only those areas under medical investigation and using other tests, such as ultrasounds and MRIs, whenever possible.

Yet problems remain. Some hospitals and freestanding imaging centers continue to administer adult-size doses of radiation to children, experts report. Facilities also sometimes scan children repeatedly without cause or expose children’s breasts, eyes, thyroids and genitals to unnecessary radiation by scanning too broadly or failing to use protective shields.

“We still have a way to go in terms of optimizing these examinations,” said Dr. Donald Frush, chief of pediatric radiology at Duke University Hospital, acknowledging the shortcomings in the medical field.

About 7 million CT scans are administered to children every year; the number is expanding nearly 10 percent annually, according to a 2008 review of radiation risks associated with CT scans for kids in Current Opinion in Pediatrics. Almost one-third of the tests are given to children in their first decade of life.”

The ending of a story is often the take-home impression for readers. This one ends with the story of an 11-year old girl with Ewing’s sarcoma who has had 10 CT scans in addition to X-rays and a positron emissions tomography scan, or PET scan.

“Too many, in my book,” said her mother, Susanne Eyles, of Mount Prospect.

At this point, the benefits from the tests — monitoring the progress of the girl’s cancer and its response to treatment — are far more important than any risks, said a pediatric oncologist.

“Unfortunately, we really don’t have the data to say whether the number of scans we’re doing are optimal,” he added.

As long as Lindsey’s doctors say imaging tests are medically necessary, “then we’ll say yes, go ahead,” her mom said. But “as a parent, I plan to keep on asking how many of these does she really need.”

It’s also a nice touch to include in a story a patient/consumer anecdote that models how informed, shared decision-making can take place. Great use of the Tribune’s time and energy.