#SCANSMART – Safe CT Imaging

Why We Want to Reduce Undue Radiation Exposure

Computed tomography, known as CT imaging, is a valuable diagnostic tool with an estimated 60 million CT scans performed annually in the United States. But as use of CT has grown, the potential for increased radiation exposure to the estimated 7 million children annually undergoing these scans has become a public health concern.

Children are particularly vulnerable to the deleterious effects of ionizing radiation. Studies have documented that low-dose radiation in childhood carries a small but significant increase in the lifetime risk for fatal cancer. Children are particularly susceptible to the effects of radiation because of the rapidly dividing cells, as well as the fact that children have a longer lifetime during which radiation-related cancers may develop. Also, until recently, the radiation dosage of most CT scans performed were not adjusted for the smaller size of children, which is recommended by the American College of Radiology.

Minor head injuries occur commonly in children and adolescents, and approximately 50 percent of children who visit hospital emergency departments with a head injury are given a CT scan. Research shows CT scans are not necessary in the immediate evaluation of minor head injuries. By utilizing clinical observation and the Pediatric Emergency Care Applied Research Network (PECARN) criteria, physicians can determine whether imaging is appropriate, reducing unnecessary exposure to radiation.

Success Within New Jersey Hospitals

Since the fall of 2016, 47 New Jersey hospitals have committed to reducing exposure to ionizing radiation in children by reducing the use of CT scans when not warranted. The NJHA Institute for Quality and Patient Safety has convened the Safe CT Imaging Collaborative with the participating hospitals to improve imaging decision making.

Our Goals Moving Ahead

The goal of the Safe CT Imaging Collaborative is to evaluate the usage of CT imaging in their institutions. Those hospitals performing low numbers of pediatric CT scans will evaluate their current practice through policy and procedures with continued improvement. For those hospitals that perform a higher number of scans, the goal is to reduce the amount by 20 percent over the 12-month collaborative period.

NJHA also is working with its members and other stakeholders to educate and engage consumers on this important issue. Our #ScanSmart toolkit provides posters and brochures to help parents, coaches and others understand that CT scans are a valuable tool for protecting our kids, but that awareness is needed about the impact of ionizing radiation.


  • Introductory Webinar - Safety Collaborative to Ensure Safe Imaging of Children – Sept. 26, 2016
  • Making the Right Choice: Using PECARN – Nov. 4, 2016
  • The Risk of Radiation in Children – Nov. 15, 2016
  • The Role of the Nurse: To CT or Not to CT – Jan. 24, 2017