Medical imaging professionals involved in CT scanning, including radiologists, radiographers and medical physicists, need to be aware of what resources, protocols and other information is available to support them when they are undertaking this specialised form of scanning on children and young people.

Information to assist you when conducting paediatric scans is available in three categories:

• protocols, resources and other guidance for both radiographers and diagnostic imaging medical physicists
• specific resources for radiographers to support them in undertaking paediatric CT scanning
• general resources to support medical imaging service providers in providing advice and obtaining consent from patients and their parents or carers.

Protocols, resources and other guidance

• The Royal Australian and New Zealand College of Radiologists (RANZCR): Recommendations for Imaging in Children in Non-dedicated Paediatric Centres.
• The RANZCR Standards of Practice require CT services to undertake a CT Image Review Self Audit on a regular basis. This self-administered audit activity is designed to ensure CT services are achieving reproducibly diagnostic quality CT images to support optimum patient outcomes.
• The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) has developed diagnostic reference levels (DRLs) for multi detector computed tomography, including paediatric patients.
• The Australian Department of Health, administers the Diagnostic Imaging Accreditation Scheme, which includes standards associated with diagnostic imaging. These standards have to be met by medical imaging providers if the services they provide are to be eligible for a Medicare payment. These standards apply regardless of whether the services are for an adult or a child.
• Available via subscription, a set of DRLs has been developed as an easy reference for both radiographers and radiologists during routine clinical practice, and allows comparison to other published DRLs as a quality measure.
• A dose optimisation trial in of 10 radiology sites in Queensland concluded that 'teaching about optimisation enabled clinically meaningful dose reduction for a variety of common adult scans'. This study is available online in the Journal of the American College of Radiology, Vol. 7, Issue 8 August 2010.
• Image Gently universal CT protocols by ‘The Alliance for Radiation Safety in Pediatric Imaging’ are now available for head, thorax and abdomen - see Development of Pediatric CT Protocols 2014.

Specific resources for radiographers

The Australian Society of Medical Imaging and Radiation Therapy has developed a learning module for radiographers, Reduction in radiation exposure to children from CT scans, to support radiographers to increase their understanding of paediatric CT scanning.

The module contains four parts:

• The sensitivity of children to radiation.
• Appropriate reduction of radiation dose from CT in children - justification for CT.
• Communication and managing children.
• Appropriate reduction of radiation dose from CT in children - optimisation.

General resources

• A brochure, ‘What you need to know about CT scans for children’, is available which explains the benefits, the risks and questions parents and carers can ask healthcare professionals. It also outlines what parents and carers can do to prepare their child for a CT scan if it is needed.
• A companion poster ‘Your child and CT scans’ includes questions and ideas for parents and carers to discuss with their child’s doctor or medical imaging provider. It is available for printing and display in patient waiting areas.
• RANZCR’s Medical Imaging Consent Guidelines provide general guidance to radiologists, their medical imaging team members and medical imaging services providers on the principles and requirements of obtaining patient consent for medical imaging examinations. This includes advice on the need for parent or guardian consent for children under 16 years.

More information

Learn more here about CT scans and radiation exposure in children and young people.