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Since its first introduction into clinical practice in the early 1970s, the number of indications for Computed Tomography (CT) have been growing. According to the 2000 report (1) of the United Nations Scientific Committee on the Effects of Atomic Radiation, the frequency of CT examinations in developed countries increased on average from 6.1 per year per 1,000 population in the 1970s to 48 per year per 1,000 population in the period between 1991 to 1996 (2). At the same time the average effective dose per CT examination increased from 1.3 mSv (millisieverts) in the 1970s to 8.8 mSv in the period between 1991 to 1996 (2). During the last two decades, CT has undergone rapid technical developments including the introduction of helical CT and multislice CT scanners which decrease or eliminate motion artifacts, acquire volumetric data in a short time with great anatomic coverage, and generate isotropic datasets which facilitate 3D reconstruction of anatomical areas (3, 4). These developments have led to a rapid increase of CT studies in both adults and children, since the clinical value of CT is unquestionable (5, 6). The estimated annual number of CT examinations in the USA rose sevenfold from 2.8 million in 1981 to 20 million in 1995 (7), and more than 62 million CT scans in 2006 including 4 million for children (8). Comparable trends have been reported in European countries such as Germany, Switzerland, Norway and UK (9). All of these data indicate that CT has become the method of choice in many clinical applications, for both adults and children. In this issue of AMJ, Ghosh and Dey (10) in their article entitled “A review on current approaches to diagnosing proptosis in paediatric patients in India” reported the diagnostic value of CT in children presenting with proptosis in rural India. They concluded that CT is the investigation of choice based on a retrospective study of 65 paediatric patients, including 55% of the children under 5 years old. A variety of abnormalities including benign and malignant tumours were studied with CT with 91% of CT findings correlating well with histopathology.

Computed Tomography and Radiation Dose: Is the Technique Appropriately Used for Imaging in Children?