Emily Hague, Imaging Performance Partnership
As the risks of radiation become more known and widely publicized, reducing exposure and managing the associated risks have become top priorities for many radiologists. A recently published review in the Journal of the American College of Radiology assessed several methods of using estimated cumulative dose data for these purposes.
The authors examine several common misconceptions about the use of cumulative dose data, and warn that it can often be interpreted irrationally and may increase perceived risk of an exam—thus causing a patient or physician to decide against a procedure that would have proven medically beneficial.
As noted by research presented at the American Roentgen Ray Society's annual meeting, patients are much more likely to die from a condition that required a CT scan than they are to die from radiation exposure from that scan. In order to ensure safety and wise decision-making, utilization protocols should be set in place and patients should be imaged only when the expected benefits of a scan outweigh the potential risks. The radiation dose should also be as low as possible, while still maintaining the quality of the image.
The Imaging Performance Partnership has identified several related best practices in the study, Managing Radiation Risk. Exposure and dose can be reduced in a several ways:
- An institutional review standardizes dosage for the same exam across different sites of care.
- Administrative controls reduce the risk of human error.
- Bismuth shielding limits radiation to the breast, eye, and thyroid.
- Applications reduce scan times and dosage, or improve image quality without increasing dose.
- Evidence-based guidelines in the ED eliminate unnecessary scans.
- Flagging of “frequent flier” patients raises awareness of physician ordering patterns.
Of course, all these tactics should be use in conjunction with a careful analysis of the risks and benefits for each individual exam.
For more information about how to control the various risks associated with radiation, read the Partnership's study, Managing Radiation Risk.
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