WRITTEN QUESTION E-2389/02

by Kathleen Van Brempt (PSE) to the Commission

(2 August 2002)

Subject: CT scans on children

Belgian hospitals make a great deal of use of nuclear diagnostics. Ionising radiation is used in medicine both for diagnosis and therapy. Radiology, which makes use of x-rays, and nuclear medicine, in which the patient takes a radioactive preparation, are still the most powerful diagnostic tools. In a recent report the UN predicts that the use of ionising radiation in diagnostics and therapy will increase still further in years to come.

The problem, however, is that children who undergo a CT (computer tomography) scan often receive a higher dose of radiation than necessary, partly because most scanners are set for adults and not adjusted. Doctors are not always aware of this. This is a problem, because children are more sensitive to ionising radiation than adults. They run between twice and 10 times the risk of contracting cancer and may suffer development problems.

Should Europe not drastically reduce this kind of therapy?

What measures does the Commission propose to take to this end?

What measures are being taken to protect children better against excessive doses of radiation?

Answer given by Mrs Wallström on behalf of the Commission

(24 September 2002)

The introduction of computer tomography (CT) has brought undoubted benefits for diagnosis and health care in general. Nonetheless, the procedure may involve significant individual doses, which need to be minimised consistently with obtaining the required diagnostic information. A fundamental requirement of radiation protection is to ensure that any practice (such as a CT scan) is justified (ie, the benefits of the procedure must outweigh any detriment) and optimised (ie, the radiation doses must be reduced to as low as reasonably achievable). The newly revised Council Directive 97/43/Euratom of 30 June 1997 on health protection of individuals against the dangers of ionizing radiation in relation to medical exposure, and repealing Directive 84/466/Euratom(1), includes specific requirements on quality assurance and patient dose assessment in CT and special practices involving children ensuring that the use of CT scans on infants is carefully justified and optimised.

Justification implies avoiding unnecessary exposures and considering other imaging modalities such as ultrasound or magnetic resonance imaging. In deciding whether to use a CT scan or other imaging tools on a child, the judgement of the physician is paramount.

When children receive CT scans, Member States have to ensure that appropriate equipment and special imaging techniques are used, the equipment is operated properly, and specially trained radiologists supervise and interpret the CT scans, so that paediatric patients are not exposed to more radiation than they should be.

The Commission will continue to ensure that the new Directive is appropriately implemented in the Member States.

The Commission will actively support a number of activities within Europe ensuring that information on new observations with potential implications for current use of CT-scans on infants is available to the relevant physicians and parents.

The Commission has funded research under its 4th and 5th Framework Programmes on quality criteria and dose reduction in CT and paediatric radiology. This topic will remain an important priority in the 6th Framework Programme, which is about to be launched.

In addition, the Commission has published Referral guidelines for imaging(2), including a chapter on paediatric imaging aiming to minimise X-ray irradiation in children, specially those with long term problems.

(1) OJ L 180, 9.7.1997.

(2) ISBN: 92-828-9454-1- http://europa.eu.int/comm/environment/radprot/118/118.htm.