Radiation Exposure Risks from CT Scans in Young Children: What Parents Should Know

Radiation from CT scans in 5-year-old children?

Dear Dr.
Wang,
My child is 5 years old.
Earlier this year, he had an X-ray of his arm at a clinic, where he was not wearing a lead apron and other body parts were not shielded.
I would like to know if full exposure to X-rays could affect his reproductive organs or other areas.
Later that same month, he suffered a direct impact to his head and underwent a CT scan of the head and possibly an X-ray of the head or chest in the emergency room.
At that time, I was not aware of the side effects of CT scans.
After returning home, I discovered that the radiation dose from a CT scan is equivalent to that of 400 chest X-rays, and that children are more sensitive to radiation during their cell division phase.
High doses of radiation could potentially lead to brain cell damage and increase the risk of cancer.
Every time I think about this, I feel depressed and anxious, and I don't want to keep reading more information that only heightens my anxiety.
Therefore, I would like to ask you, what is the risk of cancer for a 5-year-old boy under such continuous and significant radiation exposure? Do technicians adjust the dose when they see that the patient is a child? Is there a possibility that they might forget to make those adjustments? I apologize for bothering you, but I would appreciate your guidance.
Thank you from a very worried and distressed mother.

Nan guo de mama, 30~39 year old female. Ask Date: 2019/07/12

Dr. Wang Yifen reply Radiology

Hello, currently the estimation of X-ray risks is calculated based on adults.
For children, since their organs are still developing and their lifespan is much longer, the risk of radiation-induced cancer may not be accurate, and therefore no data is available for reference.
However, according to the International Commission on Radiological Protection (ICRP) report 103, doses below 100 millisieverts (including single or multiple exposures) do not cause clinical functional damage.
According to the American Society of Radiologic Technologists, the radiation exposure for an 18-year-old male receiving a standard chest X-ray, a head CT scan, and limb X-rays is approximately 2.101 millisieverts, resulting in an additional cancer risk of 0.025614%, meaning there is a 99.974386% chance of no impact.
Furthermore, diagnostic X-ray radiation exposure does not fall under high-dose radiation; high-dose radiation is associated with treatments like radiation therapy for cancer.
Therefore, a 5-year-old boy will not develop brain lesions from undergoing a head CT scan.
If the technician operating the CT scan adheres to the ALARA (As Low As Reasonably Achievable) principle during the examination, they will adjust the dose to minimize radiation exposure.
As you mentioned, children are more sensitive to radiation than adults, so it is advisable to keep a record of the child's X-ray radiation exposure history and discuss the necessity of the examination with the physician before proceeding with the X-ray, ensuring that the benefits of the examination outweigh the risks.
Additionally, do not avoid examinations out of fear of radiation, as this could lead to missing critical treatment opportunities for diseases.
Wishing you and your family peace and good health.

Reply Date: 2019/07/12

More Info

When it comes to radiation exposure from medical imaging, particularly in young children, it is understandable for parents to feel concerned. The risks associated with X-rays and CT scans can be alarming, especially when considering the sensitivity of a child's developing body.
Firstly, it is important to clarify that the radiation doses from diagnostic imaging, such as X-rays and CT scans, are generally low and are considered safe when used appropriately. For instance, a standard chest X-ray exposes a patient to about 0.1 mSv (millisieverts), while a CT scan of the abdomen may expose a patient to approximately 7 mSv. To put this in perspective, the average person is exposed to about 3 mSv of natural background radiation each year from environmental sources.
In your case, your 5-year-old child underwent a hand X-ray and a CT scan of the head after a fall. While it is true that CT scans deliver a higher dose of radiation compared to standard X-rays, the risk of developing cancer from a single CT scan is still relatively low. The lifetime risk of cancer from a single CT scan is estimated to be about 1 in 2,000 to 1 in 10,000, depending on the specific scan and the child's age. This means that while there is a slight increase in risk, it is not significant enough to cause alarm, especially when weighed against the potential benefits of diagnosing and treating medical conditions.

Regarding your concerns about the exposure of reproductive organs and other areas during the hand X-ray, the radiation from X-rays is localized, and the exposure to other body parts is minimal. However, it is always advisable to use protective measures, such as lead aprons, when possible, especially for sensitive areas.

As for the CT scan, technicians are trained to adjust the radiation dose based on the patient's age and size, following the ALARA principle (As Low As Reasonably Achievable). This means that they strive to minimize radiation exposure while still obtaining the necessary diagnostic information. It is unlikely that a technician would forget to adjust the dose for a child, but if you have concerns, it is always appropriate to discuss them with the medical staff before the procedure.

In terms of long-term effects, while children are more sensitive to radiation than adults due to their rapidly dividing cells, there is currently no conclusive evidence that a single CT scan will lead to significant long-term health issues. The key is to ensure that any imaging done is medically necessary and that the benefits outweigh the risks.

If you are still feeling anxious, it may be helpful to keep a record of your child's imaging history and discuss any future imaging needs with your healthcare provider. They can help you assess the necessity of any further scans and provide reassurance regarding the safety of the procedures.

In conclusion, while it is natural to worry about radiation exposure, especially in young children, the actual risk from a few diagnostic imaging procedures is quite low. It is essential to maintain open communication with healthcare providers about any concerns and to ensure that all imaging is justified and performed with the utmost care.

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