Over the years, I had been asked by so many specialists to get a CAT scan of Ben - even when he was a tiny infant. Our pediatrician at the time, Dr. Eileen Aicardi (who is a wonderful pediatrician in San Francisco and who really looks out for her patients), warned us that we should not expose Ben to a CAT scan at such a young age and especially if it were not absolutely critical - so we did not.
WHY RADIATION EXPOSURE IS PARTICULARLY HARMFUL TO CHILDREN
The amount of radiation that a child is exposed to from a CAT scan is hundreds of times more than an x-ray and it is at levels intended for an adult. In addition, the reason why radiation is considered dangerous and a potential carcinogen is because that radiation can cause cell mutations. It takes about 20 years for a cell mutation to become cancerous (if it's going to become cancerous). If the cell mutation happens in a 60 year old, there is much less time (between 60 and the end of the 60 year old's life) for the cells to become cancerous. In a child, there is an entire lifetime during which the cells can grow and become cancerous. Furthermore, a child goes through much more dramatic growth and development than an adult - which can also play a role in exacerbating the effect of cancerous development caused by radiation. Meanwhile, most CAT scan machines are built with only adult proportions and health needs in mind. Therefore, there are lots of reasons why it's a good idea to be circumspect about exposing your child to diagnostic imaging using radiation and especially CAT scans.
The following are some articles that discuss the potential risk of over-exposure to radiation via CAT scans.
- How Dangerous are CAT Scans? in Time Magazine
- Radiation Risks and Pediatric Computed Tomography from the National Institutes on Health
- Unnecessary CAT Scans Exposing Patients to Excessive Radiation in USA Today
Most doctors have their patient's interests at heart and would not consciously be doing otherwise. Since the machines are incredibly expensive and need to pay for themselves and they are frequently used as revenue generators for the hospitals, there's an incentive for hospitals to encourage the use of diagnostic CAT scans. Meanwhile, there is no financial incentive for hospitals to invest in additional low-dose CAT scan machines. For a few articles on this moral dilemma - here are articles from the New York Times and medical resident's perspective.
HOW DOCTORS, RADIOLOGISTS AND TECHNICIANS MAY INADVERTENTLY OVER-RADIATE PATIENTS FOR VARIOUS REASONS
Also, from the point of view of the doctor asking for the CAT scan, they think that they're the only person who has asked for the CAT scan, and they are primarily interested in seeing the results for their own diagnostic purposes. Therefore, they think they're the only one asking for a CAT scan - and one CAT scan is probably OK. But if multiple doctors are asking for multiple CAT scans, that would entail exposing a child to an enormous amount of radiation.
In addition, there have been numerous cases of hospital radiology technicians simply not knowing how to use their CAT scans machines and over-radiating their patients. Walt Bogdanich wrote a series of investigative reports in the New York Times which discuss mis-use and over-radiation in hospitals across the country including in New York, West Virginia, California, Alabama and Florida.
Here are a couple of articles, implicating Cedars Sinai (which happens to be our local hospital) and others!
- After Stroke Scans, Patient Faces Serious Health Risks by Walt Bogdanich with the New York Times
- Mediare Claims Show Overuse for CT Scanning (June 2011) by Walt Bogdanich with the New York Times
- Article from NPR Interview with Walt Bogdonich
As mentioned previously, Dr. Joseph Roberson's office had a special low dose radiation CAT scan machine made by Xoran that generates more accurate CAT scans with 1/10 the level of radiation. It's also a bonus because it doesn't require general anesthesia (that is used when taking a CAT scan of a child less than 4 years old so that they don't move through the scanning process) because the Xoran scan is done in just a few seconds.
