In a nationwide safety effort launched this week in Chicago health care providers are pledging to stop the overuse of radiation on patients during medical examinations. The pledge at the Image Wisely campaign is signed so far by nearly 700 health care providers. It pledges to use the least radiation necessary on patients for a procedure. An expert panel at a radiology meeting Thursday said the campaign may lead to more review of protocols, more accreditation of imaging facilities and more widely shared standards on proper radiation doses.
Studies have shown that too much radiation can cause cancer. The average American’s total radiation exposure has increased in recent years because of the increased use of new imaging tests, particularly CT scans, raising questions about possible increased cancer risk.
William Hendee of the Medical College of Wisconsin in Milwaukee, speaking on an imaging safety panel at the Radiological Society of North America's annual meeting in Chicago said, “There are lots of reasons that medical images are over-utilized.” He said most insurers pay doctors, with a fee for each procedure, rewarding doctors for doing more procedures. He agreed there is a definite financial incentive to do more tests. Also procedures are performed at times to protect a doctor against malpractice claims. Lack of knowledge of which test is appropriate is another problem he said. Some times patients demand a certain test they have heard or read about, Hendee said. Then there is “dose creep,” when technologists increase the radiation dose to get amazing-looking pictures of the body. Hendee said, “With digital imaging it's easy to use increased dose per procedure to yield prettier images. But you don’t need pretty images to provide information necessary to yield a diagnosis.”
The Image Wisely campaign launched this week at the RSNA meeting with ribbons, buttons, stickers, a website and a wise owl logo. Next year, hospitals and imaging facilities will be able to join a nationwide registry that will keep track of CT scan doses and warn institutions that are giving too much radiation. Priscilla Butler of the American College of Radiology, a professional society that is developing the registry said, “You don’t know that you need to improve unless you have that information from everybody else.” Dr. Christoph Wald of Tufts University Medical School in Boston encouraged patients to keep track of how many X-rays, CT scans and other radiation tests they have had. He said, “It should be stated very clearly that the dose levels that are typically used in medical imaging have a low level of risk for causing cancer… And the benefit of safe and appropriate imaging to sick people who have terrible potential diseases really outweighs the low risk of cancer.”
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