Dose Optimization to Minimize Radiation Risk for Children Undergoing CT and Nuclear Medicine Imaging is Misguided and Detrimental

Abstract

A debate exists within the medical community on whether the linear no-threshold (LNT) model of ionizing radiation exposure accurately predicts subsequent radiogenic cancer incidence. We evaluate the evidence that refutes LNT, and its corollary efforts to reduce radiation exposures for CT and nuclear medicine imaging in accord with ALARA (as low as reasonable achievable), particularly for children. Further, we review studies demonstrating that children are not, in fact, more radiosensitive than adults in the radiological imaging dose range, rendering dose reduction for children unjustifiable and counterproductive. Efforts to minimize nonexistent risks are futile and a major source of persistent radiophobia. Radiophobia is detrimental to patients and parents, induces stress, and leads to avoidance of imaging or suboptimal image quality, both increasing misdiagnoses and consequent harm, with no compensating benefits.