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What Parents Should Know About Infants and X-rays

November 01, 2011

Radiology Expert Explains Safety Measures Used During Imaging Procedures

To address parents’ concern and help answer questions about the safety of using X-ray exams on infants, a radiology expert from the Washington Outpatient Imaging Center has addressed the topic in a public service announcement now airing on Washington Hospital’s InHealth Channel, Comcast cable channel 78, and on the Web.

X-rays, used to help physicians accurately diagnose a wide variety of injuries and conditions, are forms of radiant energy, like light or radio waves, according to the American College of Radiology (ACR) and Radiological Society of North America (RSNA). These energy waves can penetrate the body, enabling a radiologist to produce pictures of internal structures, which can be viewed on photographic film, a television screen, or computer monitor.

These pictures help physicians diagnose a range of conditions and injuries, but there are specific concerns when it comes to infants and young children, according to Mimi Lin, M.D., a radiologist on the medical staff at Washington Hospital.

 “At Washington Hospital, patient safety is our first priority,” Dr. Lin explains. “We take these concerns seriously.

“As new diagnostic and therapeutic procedures utilizing ionizing radiation are discovered, there has been an increase in their use. One recent study found that by the age of 18, the average child receives more than seven radiographic exams.”

According to data published by the ACR and RSNA, the average person in the United States receives about 3 (mSv) millisieverts—the scientific unit of measurement for radiation dose—per year from naturally occurring radioactive materials and cosmic radiation from outer space. But when it comes to X-ray exams and the very young, Dr. Lin explains that infants and children require special precautions because their cells divide quickly, making them more vulnerable to the effects of radiation.

“Our approach at Washington Hospital is to always use the lowest possible dose of radiation for useful diagnostic imaging,” she says. “This is a guiding principle for any imaging procedure, regardless of age. To that end, radiation should be limited—or ‘coned’—to the area of concern. Taking full body X-rays of infants, or ‘babygrams,’ is a practice that has been widely discredited and is not done at Washington Hospital.”

Precautions taken during X-rays for infants and children, according to Dr. Lin, include proper shielding of the gonads, including breast shielding for girls, whenever possible, something she calls a crucial step in protecting these most vulnerable of patients. She adds that in certain situations, ultrasound scanning, which uses no radiation, may be effectively substituted for X-rays.

Pramela Ramachandran, M.D., neonatalogist and medical director of the Washington/Packard Children’s Special Care Nursery, also weighs in on the precautions when it comes to imaging procedures for infants.

“The whole goal is to minimize radiation to the babies while getting the essential studies done for the management of these babies,” she says. “The precise method is to limit the study to the area of concern and prevent the exposure of the babies to radiation.”

Dr. Lin goes on to explain the role of the radiological technologists, the professionals in charge of performing diagnostic X-rays safely and effectively. She points out that, in California, X-ray technicians must graduate from a post-secondary training institution approved by the state to be eligible for certification.

Upon completion of a program of study, they also must pass an examination given by the American Registry of Radiologic Technologists (ARRT) to be registered as certified X-ray technicians.

Following certification, the state also requires X-ray technicians to remain current with their skills by completing 24 hours of study every two years in the subjects of X-ray technology or safety.

Dr. Lin encourages parents of infants and young children to be active participants in their child’s care, and in the PSA she outlines questions parents should ask when their child’s physician orders a diagnostic procedure.

“As with all medical procedures, the benefits must be weighed carefully against the risks,” she says. “The bottom line is that any diagnostic test or procedure ordered for you or your child by your physician should also include a conversation about the risks and benefits involved.”

To view the public service announcement, or for more information about the Washington Outpatient Imaging Center, visit www.whhs.com/imagingcenter/ or call (510) 494-7032, extension 6461.

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