The Next Generation of CT, With a Kid-Friendly Focus

Even radiology exams with carefully minimized radiation still entail some radiation, so they aren’t completely risk-free—especially when it comes to kids. That’s why Shreyas Vasanawala, MD, PhD, radiologist in chief at Stanford Medicine Children’s Health and the William R. Brody Professor of Pediatric Radiology and Child Health, and Cedric Wilson, executive director of the Diagnostic Imaging and Anatomic Pathology Clinical Laboratories, are so enthusiastic about a new CT scanner at Lucile Packard Children’s Hospital Stanford.

A CT scanner is a kind of imaging technology that uses an X-ray camera to quickly take many pictures of the inside of the body. It then compiles these pictures to make a complete 3-D image set. It’s the best way to detect certain diseases, so radiologists often rely on it to make clear diagnoses. But even though they adhere to the ALARA (As Low As Reasonably Achievable) guidelines to minimize radiation doses, it’s still exposing the patient to radiation. “The ALARA principle is especially important for those of us in the pediatric radiology community,” says Dr. Vasanawala. “Since kids are more radiosensitive, we’re obligated to be more conscious of radiation exposure.”

The new scanner makes this ALARA dose even lower. It’s the world’s first photon-counting CT scanner, and only a handful of them have made their way into hospitals around the country. “It’s the most significant improvement in CT technology in the last 30-plus years and might even be the greatest advancement since CT’s inception,” says Wilson.

Up until now, advances in CT have been focused on imaging speed. But with this breakthrough, the technology directly converts each individual X-ray into an electrical signal, which is used to create a finely detailed image of the inside of the body, while permitting lower-dose scanning. “Stanford Children’s values preeminence, and the investment in this scanner is a prime example,” says Dr. Vasanawala. “It will lead to better diagnoses and better outcomes for our patients.”

While the scanner will be available to all patients at Stanford Children’s, it will benefit certain children in particular, by more easily catching hard-to-see abnormalities and saving repeated scans. First, there are the children who need multiple scans over many years due to chronic conditions, and this will lower their cumulative amount of radiation exposure. Second, there is the opportunity in very small babies to delineate anatomy that has been heretofore hard to capture. And finally, there’s tremendous benefit to children with conditions that are harder to see, such as abnormalities of the small bones of the inner ear and subtle lung diseases, as well as children having pulmonary artery reconstructions or those with coronary artery anomalies. “A lot of lung diseases in particular have very subtle findings, and this allows us to see the lung at a new level of detail,” says Dr. Vasanawala.

Of course, the best equipment in the world is only as good as the people operating it. “Our technologists’ skill sets and advanced scanning ability are the best in the business,” says Wilson. And, according to Dr. Vasanawala, “we have a great nursing group and child life specialists who are used to caring for critically ill patients, and our pediatric radiologists know how to interpret images for highly complicated pediatric conditions.”

The whole team is eager to see how families react to the new CT suite . “We’re making it truly kid-centric,” say Dr. Vasanawala. An overarching fear that families express is about their child’s exposure to radiation. Reducing the dose so dramatically will help give parents greater peace of mind around the exam. And the bright, cartoon-filled CT suite will also go a long way toward putting families at ease. “It’s got the inviting feeling that you’d want as a child or a parent,” says Wilson. “As with everything we do here, we aim to reduce the anxiety for kids having treatment, care, or—in our case—diagnostic testing; and we want to make it a warm, calming experience.”