Skip to main content
Top
Published in: Pediatric Radiology 13/2016

01-12-2016 | Commentary

The Think A-Head campaign: an introduction to ImageGently 2.0

Authors: Donald P. Frush, Lee S. Benjamin, Nadia Kadom, Charles G. Macias, Sally K. Snow, Sarah J. Gaskill, Emilee Palmer, Keith J. Strauss, The Think A-Head Campaign Committee

Published in: Pediatric Radiology | Issue 13/2016

Login to get access

Excerpt

A decade has passed since the inception of the Alliance for Radiation Safety in Pediatric Imaging [1]. This milestone marks a good time for a look back at what has been accomplished and what needs to be changed. Specifically, this commentary could comprise what has been achieved, what kind of impact the campaign has made on radiation safety in pediatric imaging and also, importantly, what missed opportunities or missteps have occurred that we can learn from. But the Alliance from the outset has been about moving ahead, sometimes intensely focused and sometimes with a broad visionary brush. The Alliance has focused on what is next and why this is important, and in the end, how to improve imaging care of children. The six campaigns of Image Gently illustrate this effort. These campaigns have primarily addressed modalities — computed tomography, radiography, fluoroscopy, nuclear medicine, interventional fluoroscopy, and most recently, dental imaging. The message, the messengers, and messaging [2] were the basis of these campaigns, and the campaigns have been a vehicle for education. The most recent campaign of Image Gently was rolled out Nov. 2, 2016. This campaign is the Think A-Head campaign for imaging children with minor closed head injury. What does this campaign tell us about the next 10 years of the Alliance? The answer comes from highlighting select changes, successes and challenges of the last 10 years and using these to understand the emphasis for the next 10 years, essentially Image Gently 2.0. This look back, then, will be a basis for the look ahead. …
Literature
1.
go back to reference Goske MJ, Applegate KE, Frush DP et al (2008) The Image Gently campaign: increasing CT radiation dose awareness through a national education and awareness program. Pediatr Radiol 38:265–269CrossRefPubMed Goske MJ, Applegate KE, Frush DP et al (2008) The Image Gently campaign: increasing CT radiation dose awareness through a national education and awareness program. Pediatr Radiol 38:265–269CrossRefPubMed
2.
go back to reference Strauss KJ, Frush DP, Goske MJ (2015) Image Gently campaign: making a world of difference. Med Phys Int 3:94–108 Strauss KJ, Frush DP, Goske MJ (2015) Image Gently campaign: making a world of difference. Med Phys Int 3:94–108
3.
go back to reference Frush DP (2016) Reply to Dr. Andronikou: holding on to informed use of diagnostic imaging using ionizing radiation. Pediatr Radiol [In press] Frush DP (2016) Reply to Dr. Andronikou: holding on to informed use of diagnostic imaging using ionizing radiation. Pediatr Radiol [In press]
4.
go back to reference Cohen MD (2015) ALARA, Image Gently and CT-induced cancer. Pediatr Radiol 45:465–470 Cohen MD (2015) ALARA, Image Gently and CT-induced cancer. Pediatr Radiol 45:465–470
9.
go back to reference Frush DP (2014) Deciding why and when to use CT in children: a radiologist’s perspective. Pediatr Radiol 44:404–408CrossRefPubMed Frush DP (2014) Deciding why and when to use CT in children: a radiologist’s perspective. Pediatr Radiol 44:404–408CrossRefPubMed
10.
go back to reference Levin DC, Rao VM (2016) Factors that will determine future utilization trends in diagnostic imaging. J Am Coll Radiol 13:904–908CrossRefPubMed Levin DC, Rao VM (2016) Factors that will determine future utilization trends in diagnostic imaging. J Am Coll Radiol 13:904–908CrossRefPubMed
11.
go back to reference Brink JA, Amis ES (2010) Image Wisely: a campaign to increase awareness about adult radiation protection. Radiology 257:601–602 Brink JA, Amis ES (2010) Image Wisely: a campaign to increase awareness about adult radiation protection. Radiology 257:601–602
14.
go back to reference Maguire JL, Boutis K, Uleryk EM et al (2009) Should a head-injured child receive a head CT scan? A systematic review of clinical prediction rules. Pediatrics 124:e145–e154CrossRefPubMed Maguire JL, Boutis K, Uleryk EM et al (2009) Should a head-injured child receive a head CT scan? A systematic review of clinical prediction rules. Pediatrics 124:e145–e154CrossRefPubMed
15.
go back to reference Huisman TAGM, Poretti A (2016) Trauma. In: Masdeu JC, Gonzalez RG (eds) Handbook of clinical neurology, vol. 136 (3rd series), Neuroimaging, part II. Elsevier, Atlanta Huisman TAGM, Poretti A (2016) Trauma. In: Masdeu JC, Gonzalez RG (eds) Handbook of clinical neurology, vol. 136 (3rd series), Neuroimaging, part II. Elsevier, Atlanta
16.
go back to reference Larson DB, Johnson LW, Schnell BM et al (2011) National trends in CT use in the emergency department: 1995–2007. Radiology 258:164–173CrossRefPubMed Larson DB, Johnson LW, Schnell BM et al (2011) National trends in CT use in the emergency department: 1995–2007. Radiology 258:164–173CrossRefPubMed
17.
go back to reference Korley FK, Pham JC, Kirsch TD (2010) Use of advanced radiology during visits to US emergency departments for injury-related conditions, 1998–2007. JAMA 304:1465–1471CrossRefPubMed Korley FK, Pham JC, Kirsch TD (2010) Use of advanced radiology during visits to US emergency departments for injury-related conditions, 1998–2007. JAMA 304:1465–1471CrossRefPubMed
18.
go back to reference Roudsari BS, Psoter KJ, Vavilala MS et al (2013) CT use in hospitalized pediatric trauma patients: 15-year trends in a level I pediatric and adult trauma center. Radiology 267:479–486CrossRefPubMedPubMedCentral Roudsari BS, Psoter KJ, Vavilala MS et al (2013) CT use in hospitalized pediatric trauma patients: 15-year trends in a level I pediatric and adult trauma center. Radiology 267:479–486CrossRefPubMedPubMedCentral
19.
go back to reference Macias CG, Sahouria JJ (2011) The appropriate use of CT: quality improvement and clinical decision-making in pediatric emergency medicine. Pediatr Radiol 41:S498–S504CrossRef Macias CG, Sahouria JJ (2011) The appropriate use of CT: quality improvement and clinical decision-making in pediatric emergency medicine. Pediatr Radiol 41:S498–S504CrossRef
20.
go back to reference Ryan ME, Palasis S, Saigal G et al (2014) ACR appropriateness criteria head trauma — child. J Am Coll Radiol 11:939–947CrossRefPubMed Ryan ME, Palasis S, Saigal G et al (2014) ACR appropriateness criteria head trauma — child. J Am Coll Radiol 11:939–947CrossRefPubMed
21.
go back to reference Hricak H, Brenner DJ, Adelstein SJ et al (2011) Managing radiation use in medical imaging: a multifaceted challenge. Radiology 258:889–905CrossRefPubMed Hricak H, Brenner DJ, Adelstein SJ et al (2011) Managing radiation use in medical imaging: a multifaceted challenge. Radiology 258:889–905CrossRefPubMed
22.
go back to reference Wildman Tobriner B, Chatfield M, Behnke ES, Frush DP (2014) ACR dose index registry. A resource for pediatric CT practice assessment and radiation dose estimations. Radiological Society of North America Annual Meeting 2014, Chicago Wildman Tobriner B, Chatfield M, Behnke ES, Frush DP (2014) ACR dose index registry. A resource for pediatric CT practice assessment and radiation dose estimations. Radiological Society of North America Annual Meeting 2014, Chicago
24.
go back to reference Dorfman AL, Fazel R, Einstein AJ et al (2011) Use of medical imaging procedures with ionizing radiation in children: a population-based study. Arch Pediatr Adolesc Med 165:458–464CrossRefPubMedPubMedCentral Dorfman AL, Fazel R, Einstein AJ et al (2011) Use of medical imaging procedures with ionizing radiation in children: a population-based study. Arch Pediatr Adolesc Med 165:458–464CrossRefPubMedPubMedCentral
25.
go back to reference Mettler FA, Wiest PW, Locken JA et al (2000) CT scanning: patterns of use and dose. J Radiol Prot 20:353–359CrossRefPubMed Mettler FA, Wiest PW, Locken JA et al (2000) CT scanning: patterns of use and dose. J Radiol Prot 20:353–359CrossRefPubMed
26.
go back to reference Miglioretti DL, Johnson E, Williams A et al (2013) The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk. JAMA Pediatr 167:700–707CrossRefPubMedPubMedCentral Miglioretti DL, Johnson E, Williams A et al (2013) The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk. JAMA Pediatr 167:700–707CrossRefPubMedPubMedCentral
27.
go back to reference Graves JM, Kanal KN, Vavilala MS et al (2014) Hospital-level factors associated with use of pediatric radiation dose-reduction protocols for head CT: results from a national survey. J Am Coll Radiol 11:717–724CrossRefPubMedPubMedCentral Graves JM, Kanal KN, Vavilala MS et al (2014) Hospital-level factors associated with use of pediatric radiation dose-reduction protocols for head CT: results from a national survey. J Am Coll Radiol 11:717–724CrossRefPubMedPubMedCentral
28.
go back to reference Smith-Bindman R, Lipson J, Marcus R et al (2009) Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch Intern Med 169:2078–2086CrossRefPubMedPubMedCentral Smith-Bindman R, Lipson J, Marcus R et al (2009) Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch Intern Med 169:2078–2086CrossRefPubMedPubMedCentral
29.
go back to reference Lodwick DL, Cooper JN, Kelleher KJ et al (2015) Variation in utilization of computed tomography imaging at tertiary pediatric hospitals. Pediatrics 136:e1–e8CrossRef Lodwick DL, Cooper JN, Kelleher KJ et al (2015) Variation in utilization of computed tomography imaging at tertiary pediatric hospitals. Pediatrics 136:e1–e8CrossRef
30.
go back to reference Hendee WR, Becker GJ, Borgstede JP et al (2010) Addressing overutilization in medical imaging. Radiology 257:240–245CrossRefPubMed Hendee WR, Becker GJ, Borgstede JP et al (2010) Addressing overutilization in medical imaging. Radiology 257:240–245CrossRefPubMed
31.
go back to reference Kanzaria HK, Hoffman JR, Probst MA et al (2015) Emergency physician perceptions of medically unnecessary advanced diagnostic imaging. Acad Emerg Med 22:390–398CrossRefPubMed Kanzaria HK, Hoffman JR, Probst MA et al (2015) Emergency physician perceptions of medically unnecessary advanced diagnostic imaging. Acad Emerg Med 22:390–398CrossRefPubMed
32.
go back to reference Studdert DM, Mello MM, Sage WM et al (2005) Defensive medicine among high-risk specialist physicians in a volatile malpractice environment. JAMA 293:2609–2617CrossRefPubMed Studdert DM, Mello MM, Sage WM et al (2005) Defensive medicine among high-risk specialist physicians in a volatile malpractice environment. JAMA 293:2609–2617CrossRefPubMed
33.
go back to reference Griffey RT, Jeffe DB, Bailey T (2014) Emergency physicians’ attitudes and preferences regarding computed tomography, radiation exposure, and imaging decision support. Acad Emerg Med 21:768–777CrossRefPubMedPubMedCentral Griffey RT, Jeffe DB, Bailey T (2014) Emergency physicians’ attitudes and preferences regarding computed tomography, radiation exposure, and imaging decision support. Acad Emerg Med 21:768–777CrossRefPubMedPubMedCentral
34.
go back to reference Linscott LL, Kessler MM, Kitchin DR et al (2013) CT for pediatric, acute, minor head trauma: clinician conformity to published guidelines. AJNR Am J Neuroradiol 34:1252–1256CrossRefPubMed Linscott LL, Kessler MM, Kitchin DR et al (2013) CT for pediatric, acute, minor head trauma: clinician conformity to published guidelines. AJNR Am J Neuroradiol 34:1252–1256CrossRefPubMed
35.
go back to reference Mathews J, Forsythe A, Brady Z et al (2012) Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians. BMJ 346:1–18 Mathews J, Forsythe A, Brady Z et al (2012) Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians. BMJ 346:1–18
36.
go back to reference Huang WY, Muo CH, Lin CY et al (2014) Paediatric head CT scan and subsequent risk of malignancy and benign brain tumour: a nation-wide population-based cohort study. Br J Cancer 110:2354–2360CrossRefPubMedPubMedCentral Huang WY, Muo CH, Lin CY et al (2014) Paediatric head CT scan and subsequent risk of malignancy and benign brain tumour: a nation-wide population-based cohort study. Br J Cancer 110:2354–2360CrossRefPubMedPubMedCentral
37.
go back to reference Pearce MS, Salotti JA, Little MP et al (2012) Radiation exposure from CT scans in childhood and subsequent risk of leukemia and brain tumors: a retrospective cohort study. Lancet 380:499–505CrossRefPubMedPubMedCentral Pearce MS, Salotti JA, Little MP et al (2012) Radiation exposure from CT scans in childhood and subsequent risk of leukemia and brain tumors: a retrospective cohort study. Lancet 380:499–505CrossRefPubMedPubMedCentral
38.
go back to reference Krille L, Dreger S, Schindel R et al (2015) Risk of cancer incidence before the age of 15 years after exposure to ionising radiation from computed tomography: results from a German cohort study. Radiat Environ Biophys 54:1–12CrossRefPubMed Krille L, Dreger S, Schindel R et al (2015) Risk of cancer incidence before the age of 15 years after exposure to ionising radiation from computed tomography: results from a German cohort study. Radiat Environ Biophys 54:1–12CrossRefPubMed
39.
go back to reference Journy N, Rehel JL, Ducou Le Pointe H et al (2015) Are the studies on cancer risk from CT scans biased by indication? Elements of answer from a large-scale cohort study in France. Br J Cancer 112:185–193CrossRefPubMed Journy N, Rehel JL, Ducou Le Pointe H et al (2015) Are the studies on cancer risk from CT scans biased by indication? Elements of answer from a large-scale cohort study in France. Br J Cancer 112:185–193CrossRefPubMed
40.
go back to reference Boice JD (2015) Radiation epidemiology and recent paediatric computed tomography studies. Ann ICRP 44:236–248CrossRefPubMed Boice JD (2015) Radiation epidemiology and recent paediatric computed tomography studies. Ann ICRP 44:236–248CrossRefPubMed
41.
go back to reference McCollough CH, Bushberg JT, Fletcher JG et al (2015) Answers to common questions about the use and safety of CT scans. Mayo Clin Proc 90:1380–1392CrossRefPubMed McCollough CH, Bushberg JT, Fletcher JG et al (2015) Answers to common questions about the use and safety of CT scans. Mayo Clin Proc 90:1380–1392CrossRefPubMed
42.
go back to reference Boutis K, Cogollo W, Fischer J et al (2013) Parental knowledge of potential cancer risks from exposure to computed tomography. Pediatrics 132:305–311CrossRefPubMed Boutis K, Cogollo W, Fischer J et al (2013) Parental knowledge of potential cancer risks from exposure to computed tomography. Pediatrics 132:305–311CrossRefPubMed
43.
go back to reference Lam DL, Larson DB, Eisenberg JD et al (2015) Communicating potential radiation-induced cancer risks from medical imaging directly to patients. AJR Am J Roentgenol 205:962–970CrossRefPubMed Lam DL, Larson DB, Eisenberg JD et al (2015) Communicating potential radiation-induced cancer risks from medical imaging directly to patients. AJR Am J Roentgenol 205:962–970CrossRefPubMed
44.
go back to reference Ditkofsky N, Shekhani HN, Cloutier M et al (2016) Ionizing radiation knowledge among emergency department providers. J Am Coll Radiol 13:1044–1049CrossRefPubMed Ditkofsky N, Shekhani HN, Cloutier M et al (2016) Ionizing radiation knowledge among emergency department providers. J Am Coll Radiol 13:1044–1049CrossRefPubMed
45.
go back to reference Steele JR, Jones AK, Clarke RK et al (2016) Oncology patient perceptions of the use of ionizing radiation in diagnostic imaging. J Am Coll Radiol 13:768–774CrossRefPubMed Steele JR, Jones AK, Clarke RK et al (2016) Oncology patient perceptions of the use of ionizing radiation in diagnostic imaging. J Am Coll Radiol 13:768–774CrossRefPubMed
46.
go back to reference Broder JS, Frush DP (2014) Content and style of radiation risk communication for the pediatric patients. J Am Coll Radiol 11:238–242CrossRefPubMed Broder JS, Frush DP (2014) Content and style of radiation risk communication for the pediatric patients. J Am Coll Radiol 11:238–242CrossRefPubMed
47.
go back to reference Frush DP, Frush KS (2008) ‘Sleeping with the enemy?’ Expectations and reality to imaging children in the emergency setting. Pediatr Radiol 38:S633–S638CrossRefPubMed Frush DP, Frush KS (2008) ‘Sleeping with the enemy?’ Expectations and reality to imaging children in the emergency setting. Pediatr Radiol 38:S633–S638CrossRefPubMed
49.
go back to reference Sierzenski PR, Linton OW, Frush DP et al (2014) Applications of justification and optimization in medical imaging: examples of clinical guidance for computed tomography use in emergency medicine. J Am Coll Radiol 11:36–44CrossRefPubMed Sierzenski PR, Linton OW, Frush DP et al (2014) Applications of justification and optimization in medical imaging: examples of clinical guidance for computed tomography use in emergency medicine. J Am Coll Radiol 11:36–44CrossRefPubMed
50.
go back to reference Nigrovic LE, Stack AM, Mannix RC et al (2015) Quality improvement effort to reduce cranial CTs for children with minor blunt head trauma. Pediatrics 136:e227–e233CrossRefPubMed Nigrovic LE, Stack AM, Mannix RC et al (2015) Quality improvement effort to reduce cranial CTs for children with minor blunt head trauma. Pediatrics 136:e227–e233CrossRefPubMed
51.
go back to reference Fabio Paolicchi F, Faggioni L, Bastiani L (2014) Optimizing the balance between radiation dose and image quality in pediatric head CT: findings before and after intensive radiologic staff training. AJR Am J Roentgenol 202:1309–1315CrossRefPubMed Fabio Paolicchi F, Faggioni L, Bastiani L (2014) Optimizing the balance between radiation dose and image quality in pediatric head CT: findings before and after intensive radiologic staff training. AJR Am J Roentgenol 202:1309–1315CrossRefPubMed
52.
go back to reference Kuppermann N, Holmes JF, Dayan PS et al (2009) Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet 374:1160–1170CrossRefPubMed Kuppermann N, Holmes JF, Dayan PS et al (2009) Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet 374:1160–1170CrossRefPubMed
55.
go back to reference Shyu JY, Sodickson AD (2016) Communicating radiation risk to patients and referring physicians in the emergency department setting. Br J Radiol 89:20150868CrossRefPubMed Shyu JY, Sodickson AD (2016) Communicating radiation risk to patients and referring physicians in the emergency department setting. Br J Radiol 89:20150868CrossRefPubMed
56.
go back to reference Robey TE, Edwards K, Murphy MK (2014) Barriers to computed tomography radiation risk communication in the emergency department: a qualitative analysis of patient and physician perspectives. Acad Emerg Med 21:122–129CrossRefPubMed Robey TE, Edwards K, Murphy MK (2014) Barriers to computed tomography radiation risk communication in the emergency department: a qualitative analysis of patient and physician perspectives. Acad Emerg Med 21:122–129CrossRefPubMed
Metadata
Title
The Think A-Head campaign: an introduction to ImageGently 2.0
Authors
Donald P. Frush
Lee S. Benjamin
Nadia Kadom
Charles G. Macias
Sally K. Snow
Sarah J. Gaskill
Emilee Palmer
Keith J. Strauss
The Think A-Head Campaign Committee
Publication date
01-12-2016
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Radiology / Issue 13/2016
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-016-3739-z

Other articles of this Issue 13/2016

Pediatric Radiology 13/2016 Go to the issue