Imaging Gently

Finding innovative methods to reduce unnecessary radiation exposure

Since its unveiling in the 1970s, the computed axial tomography (better known as CAT or CT) scan has revolutionized the field of medical imaging. In just seconds, a CT scan can create a complete picture of medical problems invisible to the naked eye, integrating hundreds of cross-sectional images to produce a 3-D image of both hard and soft tissue.

The perfect imaging tool for a squirmy child, or so it seemed. The challenge with improved imaging is how to use it safely, especially for children whose conditions require repeated studies over the years.

“We know that the less radiation we give, the better it will be for patients.”Diego Jaramillo, M.D., M.P.H., CHOP’s radiologist-in-chief

CHOP has been committed to reducing patients’ exposure to radiation and has led the way in raising awareness about the need for radiation reduction nationally and internationally. Jaramillo helped found Image Gently, an initiative of the Alliance for Radiation Safety in Pediatric Imaging, in 2007. The initiative is now an international movement comprised of more than 70 medical organizations worldwide dedicated to protecting children from the potentially harmful effects of imaging radiation.

Callie Monroe, age 17, who has been imaged multiple times for pneumonia and asthma, is pictured with the Hospital’s newest CT scanner, which makes exams faster and healthier for kids.

Internally, CHOP’s strategy is three-pronged:

Invest in machines that deliver less radiation.
Reduce the dose of radiological imaging to the lowest amount possible to still obtain the necessary diagnostic information.
Eliminate use completely by finding non-radioactive imaging alternatives (such as ultrasound or MRI) when possible.

Families are given a log book to keep a record of the radiologic exams their children have over time, and CHOP is working to create an electronic registry that tracks exactly how much radiation each patient receives.

The strategy is working. Since 2006, the number of CT scans performed at CHOP has decreased by about 5 percent every year. And a year ago, when hospitals within Image Gently compared notes, CHOP had the lowest dose for abdominal CT scans — and that was before the Hospital installed its new CT scanner, which produces images even faster and with much less radiation.

“One of the basic Hippocratic principles is ‘first do no harm,’ and we owe it to every child to stick to that principle,” says Jaramillo. “In diagnostic imaging, the ‘do no harm’ principle applies primarily to decreasing radiation exposure — and together, we’re finding innovative ways to do that.”

Learn more about the Department of Radiology.

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IMAGE GENTLY

In just seconds, a CT scan, like these, can create a complete picture of medical problems invisible to the naked eye, integrating hundreds of cross-sectional images to produce a 3-D image of both hard and soft tissue.