Abstract
The increasing use of medical radiation, especially in computed tomography (CT) scanning, has raised many concerns over the possible adverse effects of procedures performed without a serious consideration of risks-costs versus benefit in Japan. To understand what concrete situations are considered, particularly in childhood CT-scan, the current diagnostic radiology practice at Nagasaki University Hospital were studied through an examination of the radiology and emergency departments data of a one year period in 2004. The less than one year old children had a significantly higher share in CT examinations compared with other ages. The majority of CT requests were made by the sub-specialist in the tertiary care hospital for particular diagnostic needs so that a cost vs. benefit study appeared to favor the potential provision of valuable information by CT; however many repeated CT requests with negative results were a source of controversy. The management of minor head trauma showed a much higher than recommended level of reliance on CT examination, compared with studies in UK, Canada and USA. The hospital neurosurgery team often takes over the decision making process with considerably higher rates of request for a CT examination. Although the CT indication in University hospital is different from that in other hospitals taking on the secondary emergency care, a lower rate of CT scanning of children is generally desired in accordance with a universal guideline or own policy.
