M. M. McGuire1,2, T. A. Oyetunji3, H. T. Jackson1,4, W. Pastor1, D. I. Bulas1,4, F. G. Qureshi1,4 1Children’s National Medical Center,Surgery,Washington, DC, USA 2All Children’s Hospital,Surgery,St. Petersburg, FL, USA 3Howard University College Of Medicine,Washington, DC, USA 4George Washington University School Of Medicine And Health Sciences,Washington, DC, USA
Introduction: The Alliance for Radiation Safety in Pediatric Imaging was formed in 2006 with a goal to promote radiation protection for children undergoing imaging. In 2007 the alliance started the Image Gently campaign which promoted lower dosages and practice changes. We studied the impact of the campaign on imaging trends in children with appendicitis.
Methods: The Pediatric Health Information System (PHIS) database was queried for all cases of appendicitis from 2004-2013. Imaging type used and severity of appendicitis was collected.
Results: 104,006 cases of appendicitis were identified with 41% perforated. There was an increase in total imaging over time for all cases (59.46% in 2004 to 65.53% in 2013). Computed tomography scan (CT) use reduced from 37.97% in 2004 to 25.47% in 2013 for all patients. Concomitantly ultrasound (US) use increased for all cases from 26.88% in 2004 to 52.2% in 2013. Total imaging in perforated appendicitis trended downward (82.43% in 2004 to 65. 20% in 2013). CT scan use also decreased in perforated appendicitis from 49.60% in 2004 to 19.34% in 2013 while US increased from 38.93% in 2004 to 52.15% in 2013. There was increased CT use in all groups from 2004 to 2007 before plateauing and dropping especially in perforated appendicitis.
Conclusion: Total Imaging has increased in children with appendicitis, with an increasing use of US and reduced use of CT. CT scan use first increased and then decreased after 2007. The reduction in CT use and increase in US use may be related to the Image Gently campaign.
