The Academy of Radiology Research/CIBR has launched a new initiative, “Reducing Radiation Exposure to Americans Having Diagnostic Imaging Studies”, to address the need to manage and reduce the amount of ionizing radiation that patients receive from diagnostic imaging studies, including CT. The goal of this initiative is to develop Federal legislation that would provide funding to be administered through NIH, AHRQ, and FDA that would be targeted to finance the required research and development that can lead to improvements in this arena, and to provide Federal support to disseminate these best practices in all clinical settings, throughout the medical device industry and the national initiative to adopt electronic health records.
Below is background information on CT scanning and the issue of radiation dose.
Computed tomography (CT) scanning has gained widespread acceptance as an extremely useful tool in a wide variety of clinical conditions, ranging from trauma to oncology. CT works by applying computer and x-ray technology to create 3 dimensional images of specific organs in the body for diagnoses of disorders from cardiovascular to musculoskeletal. This breakthrough innovation for years has been embraced as the imaging technique of choice with many attractive features for patients and physicians such as its non-invasive nature. The family of ‘multi-slice’ CT scanners has become the imaging test of choice for thousands of physicians — hailed for its speed and higher spatial clarity. Although CT has shown enormous success as a diagnostic tool, there have also been warnings associated with its widespread use, particularly in the area of radiation dose. This issue has been the subject of widespread discussion with the general concern being that exposure to medical ionizing radiation could potentially lead to an increase in a patient’s lifetime risk of developing cancer. Many efforts are underway to find ways and means to reduce the amount of radiation that a patient receives through a diagnostic CT scan, or any other imaging procedure that uses ionizing radiation.
According to the FDA’s “Initiative to Reduce Unnecessary Radiation Exposure” launched in February 2010, the challenge is to find ways to avoid repeated or higher than necessary exposure to ionizing radiation in the course of a diagnostic imaging study. In the Initiative, the FDA suggests that various measures be taken to help curb the issue of radiation dose; some of these measures include – using only the ‘minimally necessary’ amount of radiation, and only when “medically justified” based on patient symptoms, providing adequate training to all personnel involved in using CT equipment, and good quality assurance. It is important to note that manufacturers also bear a large responsibility in the radiation dose issue. It is imperative that all practitioners be provided enough information and guidelines on CT equipment and its utilization. Steps should also be taken in the manufacturing process to ensure that issues of over-radiation are reduced.
Researchers are currently seeking an imaging technique that still has all the advantages and health benefits of CT, but at the same time can reduce the risks involved as much as possible. One method that is showing promise is the use of technologically advanced devices that acquire ever-larger amounts of diagnostic information, with ‘reasonable’ radiation exposure through use of ‘high end’ multi-slice CT. It is believed that these highly sophisticated multi-slice CT systems will provide enhanced diagnostic accuracy at lower radiation doses in various applications, such as cardiac CT.
CT scans’ contribution in radiology and medicine in general cannot be overstated. However, the issue of radiation dose must be managed to ensure that the benefits of this test far outweigh its risks. In order to ensure the optimum use of CT scanning, the medical imaging community and device manufacturers must come together to develop and test optimal configurations, protocols and use of these amazingly powerful CT devices.
Further information on the FDA’s initiative can be found at http://www.fda.gov/Radiation-EmittingProducts/RadiationSafety/RadiationDoseReduction/ucm199904.htm.