Image Gently^TM Pediatric Campaign  

Image Gently^TM Pediatric Campaign Educates Providers of Pediatric Imaging on the Need to “Child-Size” Radiation Dose

On January 22, 2008, the charter members of the Alliance for Radiation Safety in Pediatric Imaging—the Society for Pediatric Radiology, the American College of Radiology, the American Society of Radiologic Technologists, and the American Association of Physicists in Medicine—launched the highly anticipated Image Gently campaign, a national initiative that will educate providers of pediatric imaging care about the importance of “child-sizing” radiation doses. CRCPD joined the Alliance in October as an affiliate organization. The program fits well within the mission of CRCPD in reducing unnecessary exposure to radiation.

The campaign’s central message is that children may be more sensitive to radiation received from medical imaging scans than adults, and that cumulative radiation exposure to their smaller bodies could, over time, have adverse effects. Therefore, radiologists who perform imaging exams on children are being urged to:

• “Child-size” the scan: this often reduces the amount of radiation used

• Scan only when necessary

• Scan only the indicated region

• Scan once; multiphase scanning is usually not necessary in children

• Be a team player

• Involve medical physicists to monitor pediatric CT techniques       

• Involve technologists to optimize scanning

During the campaign’s rollout phase, the message will focus on computed tomography (CT) scans. In 2006, U.S. physicians performed approximately 4 million pediatric CT scans — triple the number from five years ago. CT is a powerful modality that continues to replace more invasive and costlier non-CT techniques, but as technology evolves, the Image Gently campaign will help to ensure that medical protocols for pediatric imaging are keeping pace.

“CT is a great imaging modality that has revolutionized medical practice and saved countless lives, but it’s also among the higher dose examinations we perform,” said Donald P. Frush, M.D., Chair of the ACR Pediatric Radiology Commission. “We want to ensure that children are imaged using kid-sized, not adult-sized, radiation doses.”

“A national campaign is important,” said Marilyn Goske, M.D., Chair of the Alliance for Safety in Pediatric Imaging and Chair of the Board of Directors of the Society for Pediatric Radiology. “Medicine evolves; as we increase our knowledge, we have to change our practice.”
 

Radiologic technologist Allen Croat, R.T. (R)(CT), Chair of ASRT’s CT Chapter, said the campaign’s message is needed. “Technologists are the ones who are actually imaging these children, so we welcome the campaign’s emphasis on the ALARA format: As Low as Reasonably Achievable. We have to be protocoling our patients with our radiologists and imaging only what is necessary for the diagnosis.”

The campaign’s “radiation matters” theme drives home two fundamental concepts. One, more imaging is usually not better, and two, the effects of pediatric imaging last a lifetime. Correct dosage is key, Frush said. “Just as the appropriate dose of an antibiotic given to a child differs from the dose given to an adult, a small child needs a much smaller radiation dose than an adult.”

The focus on children makes sense. “The relative risk to a young pediatric patient is higher compared to a 70-year-old adult because the child typically has a much longer lifespan after being imaged,” said James M. Hevezi, Ph.D., medical physicist and Chair of the ACR Commission on Medical Physics. An overdose by medicine may produce obvious, immediate symptoms, but radiation is an invisible medium whose effects from overdose might not be seen for years.
 

Frush sees radiologists as having a special duty to young patients. “They entrust their care to their parents and to us as health care providers. We need to guard their welfare. We don’t know what’s going to happen, but at age 40 or 50 they may need a dozen or more CT scans. If they were scanned five scans as a kid, that’s a cumulative dose that doesn’t go away.”

The Image GentlyTM campaign will target three audiences, Goske said. The first are radiologists, medical physicists and technologists who primarily work in adult hospitals or imaging centers and who image children as a very small part of their patient volume. Second, it will target referring ER physicians, pediatricians, pediatric orthopedists and other physicians. Last, and once the medical core is educated, the campaign will reach out to parents.

Radiation exposure is a serious matter, but Frush and Goske counsel perspective. All medical procedures entail some degree of risk, they said. Studies have repeatedly shown CT to be highly accurate and have a positive impact on patient care.
 

Alliance for Radiation Safety in Pediatric Imaging

 

Founding organizations:	Affiliate Alliance organizations:
Society for Pediatric Radiology	American Academy of Pediatrics
American College of Radiology	American Osteopathic College of Radiology
American Society of Radiologic Technologists	American Registry of Radiologic Technologists
American Association of Physicists in Medicine	American Roentgen Ray Society
	Association of University Radiologists
	Conference of Radiation Control Program Directors
	National Council on Radiation Protection & Measurements
	Radiological Society of North America
	Society of Computed Body Tomography and Magnetic Resonance
	Society of Radiologists in Ultrasound

How Can CRCPD Members Be Involved?
During the January 23, 2008, CRCPD Board of Directors meeting, the Board assigned the production of a poster or brochure concerning pediatric CT to the Committee on Public Information, with input from the Task Force on CT. The information materials will be available for radiation control program staff to distribute during inspections of CT facilities. Other target audiences will be identified as well. Once the information is ready for distribution, a notice will be sent to the membership.

Through the joint efforts of the various organizations, information on the need and methods for “child-sizing” pediatric CT examinations can get to the radiology, pediatric medicine, and emergency medicine communities.

 

The Image Gently Web site www.imagegently.org/ contains the latest information and protocol guidance to help imaging providers determine and develop the appropriate radiation techniques to use in the imaging of children.

Fig. 1 —Sample advertisement used for educational and awareness campaign conducted by Alliance for Radiation Safety in Pediatric Imaging, a 13-member organization consisting of leading medical societies, agencies, and regulatory groups that have joined forces to impact patient care and change practice.

[Page created 3/30/08]

Throughout our website,   appears at links that leave the CRCPD website. (For more information, refer to Legal Stuff.)
 

A number of the documents on CRCPD's website are in PDF format; you will need the Adobe Acrobat Reader to read or print them.  You may download this program free of charge from Adobe by clicking on "Get Acrobat Reader."