From the Guidelines
CT scans on infants should only be performed when medically necessary and ordered by a physician, using specialized pediatric protocols to minimize radiation exposure, with proactive patient preparation and lowest possible radiation dose that still results in appropriate quality images. When performing a CT scan on an infant, it is essential to follow optimal CT techniques, including volumetric imaging of the entire chest on both inspiration and expiration, and using strategies to reduce radiation dose, such as suspending the automatic exposure control function and applying a specific tube voltage and current according to patient size 1. The decision to perform a CT scan on an infant should be made with caution, considering the risks of radiation exposure and the potential benefits of the scan. If there are concerns about a child's health, it is crucial to consult their pediatrician for appropriate evaluation and care. In general, CT scans should be used judiciously in pediatric patients, and alternative imaging modalities, such as ultrasound, should be considered when possible, especially in cases where the diagnosis is uncertain or the patient is at high risk for radiation exposure 1. Institutional considerations, such as the availability of pediatric-specific protocols and size adjustments, as well as access to remote imaging consultation from a pediatric radiologist, are also essential in ensuring the safe and effective use of CT scans in infants 1. Ultimately, the goal is to minimize radiation exposure while still obtaining high-quality images that can inform diagnosis and treatment decisions, and this can be achieved by following evidence-based guidelines and using specialized pediatric protocols 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Performing a Computed Tomography (CT) Scan in an Infant
To perform a CT scan in an infant, several factors need to be considered to ensure the scan is done safely and effectively.
- Limiting Radiation Exposure: It is crucial to limit radiation exposure in infants due to their higher sensitivity to radiation compared to adults 2, 3. This can be achieved by following the ALARA (as low as reasonably achievable) principle, which involves performing only necessary examinations, limiting the region of coverage, and adjusting individual CT settings based on indication, region imaged, and size of the child.
- Sedation: Sedation may be required for some infants to ensure they remain still during the scan. However, the use of sedation should be minimized, and alternative methods should be considered 4, 5. If sedation is necessary, midazolam can be used as a sole agent for sedation in pediatric patients, with a recommended dose of 0.2 mg/kg 5.
- CT Scan Protocol: A pediatric age and query adapted CT protocol should be used, taking into account factors such as body size, mass, density, proportions, and metabolism 3. The protocol should include settings for scout view, scan length, exposure settings, type of scanning, slice thickness, pitch values, and image reconstruction parameters.
- Image Quality: The image quality of the CT scan should be optimized while minimizing radiation exposure. This can be achieved by adjusting the CT settings and using alternative imaging protocols 6, 3.
- Monitoring and Care: Infants should be closely monitored during and after the CT scan, and their vital signs should be checked regularly. The CT scan room should be equipped with necessary emergency equipment, and a pediatric radiologist should be available to provide guidance and support 4, 5.