We implemented the program for the diminishing of radiation: 1st - refuse unnecessary x-ray or CT-scan examinations, 2nd - substitute x-ray and CT- scan by non-radiation methods, 3rd - implement a new generation of x-ray and CT-scan, 4th - Cooperation with international subjects, 5th - Introducing the Euro-Safe guidelines (fig. 1).
1st – refuse unnecessary x-ray or CT-scan examinations.
Psychological aspects. X-ray overexposure can be: a) iatrogenic, b) patient-genic.
a) Iatrogenic x-ray overexposure can be of pathological processes which are very clear using ultrasound or MRI but for the reinsurance the pathology referring the patients to the X-ray, native CT-scan, CT-scan with the contrasts, PET-CT-scan.
b) Patient-genic x-ray overexposure can be very rare due-to kid’s parent’s psychological problems. It can happen if the children or family have insurance coverage for all types of examination; patient’s parents impose their opinion to do “modern” types of examinations.
Medical aspects. We refuse x-ray examinations for thymus hyperplasia widely used previously in the pediatry as the standard and limited the number of x-ray or CT-scan follow-up.
2nd – To avoid x-ray exposure we often used ultrasound for an emergency. Ultrasound was used also in the operation room during neurosurgery (Fig.2.) and thorax surgery, as the guide for the precise FNA or core biopsy of the mediastinum (Fig.3.), soft tissues masses or fluid collection for follow up after brain, head and neck, thorax (Fig.4. and Fig.5.) and abdomen surgery. In some cases, (hiatal hernia, polyps), we used endoscopy instead of barium contrast x-ray. MRI was used in some brain and trauma pathology instead of CT scan or for the follow-up.
3rd - In the hospital, we changed conventional x-ray machines to digital x-ray machines and starting to use the last generation of low doses CT-scan for the pediatric practice.
4th - The cooperation with international children, hospitals are the key factor. A good example is the IAEA survey of pediatric computed tomography practice in 40 countries in Asia, Europe, Latin America and Africa: procedures and protocols European Society of Radiology 2012. European Society of Radiology 2012.
5th - Introduction of guidelines of Euro-Safe “Ask Euro-Safe Imaging Tips & Tricks Pediatrics Imaging Working Group”.