DIAGNOSTIC VALUE AND RADIATION SAFETY CONSIDERATIONS OF COMPUTED TOMOGRAPHY IMAGING IN NEONATES: LITERATURE REVIEW

Abstract

Background: Neonatal patients, particularly those in incubators, present unique diagnostic challenges due to physiological variability, high radiosensitivity, and susceptibility to complications. While ultrasound (US) and magnetic resonance imaging (MRI) are commonly preferred to minimize radiation exposure, the use of computed tomography (CT) is increasing in certain clinical contexts.

Purpose: This study aimed to evaluate the advantages and limitations of CT imaging in neonates, compare it with alternative modalities such as US and MRI, and identify strategies to optimize imaging while minimizing radiation exposure.

Methods: A systematic literature review was conducted using search terms including “neonate,” “incubator,” “very low birth weight,” “CT,” and “radiographic imaging.” Relevant studies addressing neonatal imaging techniques, clinical utility, and safety were analyzed. Key factors such as image quality, diagnostic performance, radiation exposure, and procedural feasibility were compared across imaging modalities.

Results: Ultrasound is cost-effective, portable, and safe, providing real-time evaluation for conditions such as intraventricular hemorrhage and hydrocephalus, but it is limited by lower resolution and operator dependency. MRI offers superior soft-tissue contrast, high-resolution imaging, and functional information, but is constrained by long scan times, high cost, need for sedation, and transport-related risks. CT provides rapid, high-resolution imaging, less sensitivity to motion artifacts, reproducibility independent of operator skill, and 3D reconstruction capabilities. Mobile CT further minimizes in-hospital transport. However, ionizing radiation poses long-term carcinogenic risks, particularly in radiosensitive neonatal tissues. Low-dose CT protocols, optimized pitch, gantry rotation, collimation, and neonatal-specific scan parameters can significantly reduce radiation exposure while maintaining diagnostic quality.

Conclusion: CT imaging remains a valuable tool for rapid and precise neonatal diagnostics, especially in acute or complex conditions. Careful justification, use of low-dose protocols, and patient-specific imaging strategies are essential to balance diagnostic benefits with potential radiation risks. Integration of alternative modalities such as US and MRI should be considered when appropriate to minimize cumulative exposure.