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. 2020 Dec 9:7:100290.
doi: 10.1016/j.ejro.2020.100290. eCollection 2020.

Trends of computed tomography use among children in Finland

Jad Abuhamed  1   2 , Atte Nikkilä  3 , Olli Lohi  3   4 , Anssi Auvinen  1   2
Affiliations

Trends of computed tomography use among children in Finland

Jad Abuhamed et al. Eur J Radiol Open. .

Abstract

Objectives: CT is an essential diagnostic tool in health care. However, CT delivers relatively high levels of radiation which has been associated with an increased risk of childhood cancer. To address this, we evaluated patterns and time trends of CT use among children in Finland during the period in which changes in pediatric CT imaging practices were reported in several countries.

Methods: Data on CTs performed on children younger than 15 years were obtained from Finland's largest eight hospitals. CT data included the period 1996-2010 with an estimated coverage of more than 80 % of pediatric CT imaging in Finland. Joinpoint regression was used for trends analysis. CT radiation doses were estimated based on a Finnish dosimetry survey.

Results: A total of 48,807 pediatric CTs were performed in 1996-2010. More boys (55.5 %) were scanned than girls (42.8 %). CT numbers increased up to 2002, then decreased significantly (-6.9 % per year, 95 % CI: -10.4 to -3.2) towards 2005 and to a lesser extent thereafter, particularly among younger children. All CT types decreased in recent years, except for chest, spine, and extremities. The frequency of head CTs related to the diagnoses of intracranial injury, migraine and headache decreased towards the end of the study period. The estimated annual average effective dose from the three most common CT examinations was 0.004 mSv per child in the population.

Conclusions: The frequency of pediatric CTs in Finland started to decrease after 2002. Apart from chest and orthopedic CTs, the utilization of pediatric CT imaging declined in recent years, most likely explained by improved awareness of medical radiation risks and reliance on alternative modalities such as MRI and ultrasound.

Keywords: APC, annual percentage change; Brain; CTDIvol, volume computed tomography dose index; Computed tomography; DLP, dose length product; Dosimetry; Imaging; PECARN, pediatric emergency care applied research network; Pediatric; RBM, red bone marrow; Radiation protection; STUK, Radiation and Nuclear Safety Authority; mGy, milligray; mSv, millisievert; person-Sv, person-sievert.

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Conflict of interest statement

The authors report no declarations of interest.

Figures

Fig. 1
Fig. 1
Frequency trends of CT examinations by hospital type.
Fig. 2
Fig. 2
Frequency trends of CT examinations by age group.
Fig. 3
Fig. 3
Frequency trends of head/neck CT examinations by age group.
Fig. 4
Fig. 4
Frequency trends of CT examinations by examination type excluding head/neck CTs.
Fig. 5
Fig. 5
Numbers of CT examinations per individual.
Fig. 6
Fig. 6
Frequency trends of head/neck CT examinations by related clinical diagnosis (data from three university hospitals).
See this image and copyright information in PMC

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