Strategies to minimize medical radiation exposure

Representatives from the American College of Radiology outlined strategies for transforming computed tomography (CT) technology and its use to minimize medical radiation exposure today at the National Institutes of Health "Summit to Focus on Management of Radiation Dose in Computerized Tomography – Emphasis Toward the Sub-mSv CT Exam."

"As the stewards of medical radiation technology and safety for the past 100 years, radiologists take seriously the responsibility to provide leadership in creating policies to help ensure that patients receive only necessary care; and when imaging is appropriate, that those we care for receive the right exam for the right indication at the right time," said John A. Patti, MD, FACR, chair of the ACR Board of Chancellors. "The government, manufacturers and imaging providers need to work together to arrive at quality-based imaging utilization and safety policies to ensure that patients get safe, quality care."

Imaging exams save millions of lives each year. Scans are directly linked to longer life expectancy and declining death rates. The responsible use of radiation is essential to continuing these patient benefits.

"ACR accreditation decreases duplicate scans and unnecessary radiation exposure by requiring basic physician training standards for imaging providers, regular surveys of scanners by a medical physicist and certification of radiologic technologists. Image quality requirements must be part of accreditation requirements if we are to take serious steps to raise and maintain quality and safety in medical imaging," said James A. Brink, MD, chair, ACR Body Imaging Commission, who presented at the NIH summit on the role of the ACR accreditation program in reducing overall dose and improving quality moving forward.

As the medical professionals with extensive training and unique expertise in the effects of radiation, radiologists and medical physicists have long worked to minimize dose from individual scans, avoid unnecessary exams and help other providers do so.

"The ACR CT Dose Index Registry allows facilities to submit anonymous patient dose information for each CT exam and compare their doses against national benchmarks. The system will alert them when thresholds are exceeded. This registry provides ongoing feedback that can help providers ensure, over the long term, that their patients receive optimal radiation dose," said Richard L. Morin, PhD, chair of the ACR Safety Committee, who took part in a primary panel discussion and will serve as moderator for the second session of the NIH summit.

Computerized decision support software, based on ACR Appropriateness Criteria®, help doctors prescribe the most appropriate scan for the patient's condition and reduce unnecessary exams. These systems can educate providers and help ensure proper imaging without taking important decisions out of the doctor's hands.

"Accreditation, decision support systems and the CT dose registry programs can reduce adverse events, unwarranted radiation exposure and unnecessary cost if Congress would vote to require all imaging providers — including hospitals — to participate in them," said Patti. "Now, when imaging providers and government agencies are coming together to arrive at better imaging policy is the time for Congress to act to require participation in these programs and help ensure quality and safety of medical imaging care."

The ACR is also working with other medical societies to help raise and maintain quality while ensuring that patients only receive safe, necessary care.

The Image Gently campaign (www.imagegently.org) seeks to raise awareness of opportunities to lower the radiation dose used in the imaging of children. The Campaign's Alliance involves more than 60 medical societies and 700,000 medical professionals worldwide. The effort, co-founded by the ACR, Society for Pediatric Radiology, American Association of Physicists in Medicine and the American Society of Radiologic Technologists, is widely recognized as improving radiation protection for children around the globe.

"Children are more sensitive to radiation received from imaging scans than adults. It is vitally important that we 'kid-size' the dose when performing CT exams on children. There is always more that can be done, but the Image Gently program is a promising example of imaging stakeholders working together to help ensure that those we care for receive safe, appropriate care," said Donald P. Frush, MD, chair, ACR Pediatric Imaging Commission, member of Image Gently Steering Committee, who presented at the NIH summit on the importance of education, awareness and advocacy for CT quality and safety in imaging of children.

The College is a founding member of the Image Wisely initiative (www.imagewisely.org) to help ensure that medical imaging protocols for adults keep pace with advancing technology by helping referring physicians and medical imaging professionals understand which exams may be most appropriate and how these exams may be carried out in a safe, effective manner.

"The ACR continues to work on a number of fronts to improve and maintain the quality of care that our patients receive. We look forward to working with Congress, government agencies, and other imaging stakeholders to arrive at sound, quality based, imaging policy to benefit our patients and the American health care system overall," said Patti.

SOURCE American College of Radiology