Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Child's Nervous System
Published in: Child's Nervous System 2/2021

01-02-2021 | Computed Tomography | Original Article

Radiation safety education and diagnostic imaging in pediatric patients with surgically treated hydrocephalus: the patient and family perspective

Authors: Diane Armao, Terry S. Hartman, Laurence Katz, Christopher M. Shea, Jenna Koschnitzky, Richard Yang, J. Keith Smith, Carolyn Quinsey

Published in: Child's Nervous System | Issue 2/2021

Login to get access

Abstract

Purpose

Surgically treated hydrocephalus patients are frequently imaged with head computed tomography (CT), and risk/benefit communication with families is inconsistent and unknown. We aimed to educate patients and caregivers about radiation safety in CT and explore their communication preferences.

Methods

We conducted a pediatric CT radiation safety and diagnostic imaging educational workshop for patients and caregivers at a national conference on hydrocephalus to characterize current practice and desired communication about CT imaging. Our workshop consisted of an interactive educational intervention with pre-/post-session surveys followed by feedback from participants.

Results

Our session included 34 participants (100% response rate for surveys) with 28 being parents of individuals with hydrocephalus. A total of 76% (n = 26) participants showed an increase in knowledge after the session (p < 0.01). All participants (N = 34) uniformly desired risk/benefit discussions before CT scans. However, 71% stated that they were not informed of risks/benefits of CT scans by a medical professional. Following the session, the number of participants indicating that informed consent should be obtained before CT scans increased from 30 to 33. Respondents also revealed that 14% of children and young adults had received > 100 CT scans for shunt evaluation with the median being 25 scans (IQR 20).

Conclusions

Caregivers desire and deserve to be empowered through education and social support, and continuously engaged through sharing decisions and co-designing care plans. The neurosurgical community is in an ideal position to collaborate with radiologists, primary care providers, and parents in the development and testing of credible, high-quality online and social media resources.
Appendix
Available only for authorised users
Literature
1.
2.
Armao D, Eias J, Semelka R (2013) Are we doing the right study? In: Semelka R, Elias J (eds) Healthcare Reform in Radiology. Wiley-Blackwell, New York, pp 86–114CrossRef
3.
Armao DM, Smith JK, Semelka RC (2015) Debriefing the brief: it is time for the provision of informed consent before pediatric CT. Radiology 275(2):326–330CrossRef
4.
Armao D et al (2018) Maximizing benefit and minimizing risk in medical imaging use: an educational primer for health care professions students. J Med Educ Curric Dev 5:2382120518798812PubMedPubMedCentral
5.
Boyle TP, Nigrovic LE (2015) Radiographic evaluation of pediatric cerebrospinal fluid shunt malfunction in the emergency setting. Pediatr Emerg Care 31(6):435–440 quiz 441-3CrossRef
6.
Brenner DJ (2014) What we know and what we don't know about cancer risks associated with radiation doses from radiological imaging. Br J Radiol 87(1035):20130629CrossRef
7.
Brenner DJ, Hall EJ (2007) Computed tomography--an increasing source of radiation exposure. N Engl J Med 357(22):2277–2284CrossRef
8.
DeFlorio RM, Shah CC (2014) Techniques that decrease or eliminate ionizing radiation for evaluation of ventricular shunts in children with hydrocephalus. Semin Ultrasound CT MR 35(4):365–373CrossRef
9.
Ditkofsky N, Shekhani HN, Cloutier M, Chen ZN, Zhang C, Hanna TN (2016) Ionizing radiation knowledge among emergency department providers. J Am Coll Radiol 13(9):1044–1049 e1CrossRef
10.
Elkarim GA, Alotaibi NM, Samuel N, Wang S, Ibrahim GM, Fallah A, Weil AG, Kulkarni AV (2017) Social media networking in pediatric hydrocephalus: a point-prevalence analysis of utilization. J Neurosurg Pediatr 20(2):119–124CrossRef
11.
Florin TA, Aronson PL, Hall M, Kharbanda AB, Shah SS, Freedman SB, Alpern ER, Mistry RD, Simon HK, Berry J, Coley BD, Neuman MI (2015) Emergency department use of computed tomography for children with ventricular shunts. J Pediatr 167(6):1382–1388 e2CrossRef
12.
Frush K (2014) Why and when to use CT in children: perspective of a pediatric emergency medicine physician. Pediatr Radiol 44(Suppl 3):409–413CrossRef
13.
Frush DP (2017) Meeting the needs for radiation protection: diagnostic imaging. Health Phys 112(2):214–219CrossRef
14.
Hobbs JB et al (2018) Physician knowledge of radiation exposure and risk in medical imaging. J Am Coll Radiol 15(1 Pt A):34–43CrossRef
15.
16.
17.
Jonczyk-Potoczna K et al (2019) The awareness of caregivers about their children's exposure to ionizing radiation accompanying medical procedures: the assessment study. Int J Occup Med Environ Health 32(1):65–73PubMed
18.
Karsli T, Kalra MK, Self JL, Rosenfeld JA, Butler S, Simoneaux S (2009) What physicians think about the need for informed consent for communicating the risk of cancer from low-dose radiation. Pediatr Radiol 39(9):917–925CrossRef
19.
Lam DL, Larson DB, Eisenberg JD, Forman HP, Lee CI (2015) Communicating potential radiation-induced cancer risks from medical imaging directly to patients. AJR Am J Roentgenol 205(5):962–970CrossRef
20.
Malone J, Guleria R, Craven C, Horton P, Järvinen H, Mayo J, O’reilly G, Picano E, Remedios D, le Heron J, Rehani M, Holmberg O, Czarwinski R (2012) Justification of diagnostic medical exposures: some practical issues. Report of an International Atomic Energy Agency Consultation. Br J Radiol 85(1013):523–538CrossRef
21.
Naftel RP, Tubergen E, Shannon CN, Gran KA, Vance EH, Oakes WJ, Blount JP, Wellons JC (2012) Parental recognition of shunt failure: a prospective single-institution study. J Neurosurg Pediatr 9(4):363–371CrossRef
22.
Naftel RP, Safiano NA, Falola MI, Shannon CN, Wellons JC, Johnston JM (2013) Technology preferences among caregivers of children with hydrocephalus. J Neurosurg Pediatr 11(1):26–36CrossRef
23.
Nagayama Y, Oda S, Nakaura T, Tsuji A, Urata J, Furusawa M, Utsunomiya D, Funama Y, Kidoh M, Yamashita Y (2018) Radiation dose reduction at pediatric CT: use of low tube voltage and iterative reconstruction. Radiographics 38(5):1421–1440CrossRef
24.
Pahade JK, Trout AT, Zhang B, Bhambhvani P, Muse VV, Delaney LR, Zucker EJ, Pandharipande PV, Brink JA, Goske MJ (2018) What patients want to know about imaging examinations: a multiinstitutional U.S. survey in adult and pediatric teaching hospitals on patient preferences for receiving information before radiologic examinations. Radiology 287(2):554–562CrossRef
25.
Pearce MS, Salotti JA, Little MP, McHugh K, Lee C, Kim KP, Howe NL, Ronckers CM, Rajaraman P, Craft AW, Parker L, Berrington de González A (2012) Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet 380(9840):499–505CrossRef
26.
Pindrik J, Huisman TAGM, Mahesh M, Tekes A, Ahn ES (2013) Analysis of limited-sequence head computed tomography for children with shunted hydrocephalus: potential to reduce diagnostic radiation exposure. J Neurosurg Pediatr 12(5):491–500CrossRef
27.
Rosenkrantz AB, Hanna TN, Babb JS, Duszak R Jr (2017) Changes in emergency department imaging: perspectives from national patient surveys over two decades. J Am Coll Radiol 14(10):1282–1290CrossRef
28.
Sadigh G et al (2018) Noncontrast head CT in children: national variation in radiation dose indices in the United States. AJNR Am J Neuroradiol 39(8):1400–1405PubMedPubMedCentral
29.
Semelka RC, Armao DM, Elias J Jr, Picano E (2012) The information imperative: is it time for an informed consent process explaining the risks of medical radiation? Radiology 262(1):15–18CrossRef
30.
Shellshear D, Snelling PJ, O’Brien A, Barrett MJ (2018) Emergency point-of-care ultrasound identification of pediatric ventriculoperitoneal shunt malfunctions. Pediatr Emerg Care 34(1):61–63CrossRef
31.
Smith J (2015) Parent-professional collaboration when a child presents with potential shunt malfunction. Nurs Child Young People 27(1):22–27CrossRef
32.
Smith J, Cheater F, Bekker H (2015) Parents’ experiences of living with a child with hydrocephalus: a cross-sectional interview-based study. Health Expect 18(5):1709–1720CrossRef
33.
Smyth MD, Narayan P, Tubbs RS, Leonard JR, Park TS, Loukas M, Grabb PA (2008) Cumulative diagnostic radiation exposure in children with ventriculoperitoneal shunts: a review. Childs Nerv Syst 24(4):493–497CrossRef
34.
35.
Stones SR, Smith J (2018) Social media supremacy: a force of change paving the way for the next generation of healthcare and research. Evid Based Nurs 21(1):2–3CrossRef
36.
Strauss KJ, Somasundaram E, Sengupta D, Marin JR, Brady SL (2019) Radiation dose for pediatric CT: comparison of pediatric versus adult imaging facilities. Radiology 291(1):158–167CrossRef
37.
Tekes A et al (2018) Ultrafast brain MRI can be used for indications beyond shunted hydrocephalus in pediatric patients. AJNR Am J Neuroradiol 39(8):1515–1518PubMedPubMedCentral
38.
Udayasankar UK, Braithwaite K, Arvaniti M, Tudorascu D, Small WC, Little S, Palasis S (2008) Low-dose nonenhanced head CT protocol for follow-up evaluation of children with ventriculoperitoneal shunt: reduction of radiation and effect on image quality. AJNR Am J Neuroradiol 29(4):802–806CrossRef
39.
Weiner M, Biondich P (2006) The influence of information technology on patient-physician relationships. J Gen Intern Med 21(Suppl 1):S35–S39CrossRef
40.
Metadata
Title
Radiation safety education and diagnostic imaging in pediatric patients with surgically treated hydrocephalus: the patient and family perspective
Authors
Diane Armao
Terry S. Hartman
Laurence Katz
Christopher M. Shea
Jenna Koschnitzky
Richard Yang
J. Keith Smith
Carolyn Quinsey
Publication date
01-02-2021
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 2/2021
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-020-04822-0

Other articles of this Issue 2/2021

Child's Nervous System 2/2021 Go to the issue

Case Report

C2 spinal nerve tumors in young adults: report of two cases and review of the literature

Original Article

Ventriculoatrial and ventriculopleural shunts as second-line surgical treatment have equivalent revision, infection, and survival rates in paediatric hydrocephalus

Original Article

Pineal region tumors: an entity with crucial anatomical nuances

Letter to the Editor’s Reply

Reply to Letter to the Editor: “Improved trunk and neck control after selective dorsal rhizotomy in children with spastic cerebral palsy” by Tacchino et al. (2020)

Case Report

Intracranial extra-axial mesenchymal chondrosarcoma in a 16-month-old patient with a literature review of pediatric patients

Original Article

A model for global surgical training and capacity development: the Children’s of Alabama–Viet Nam pediatric neurosurgery partnership