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Radiology Summit Gathers Experts to Discuss CT Dose Reduction Strategies

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Medical radiation dose reduction With all the concern about radiation exposure raised by the Japanese nuclear disaster, airport scanners and treatment errors in New York, the twin issues of safety and dose reduction in healthcare are now beginning to emerge into public awareness.

What the public doesn’t realize is that these have long been hot topics in the radiology community ever since the Biological Effects of Ionizing Radiation (BEIR) VII report in 2005.  The BEIR committee concluded that the biological and biophysical data supports a linear no-threshold (LNT) risk estimate model that indicates that even the smallest dose of low-level ionizing radiation has the potential to cause an increase in health risks to humans [1]

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That report has spawned numerous studies aimed at developing and evaluating the efficacy of reduced dose imaging, testing and therapy.

One such study highlighted by The Hub this past week was a meta-analysis of recent studies of Low-Dose CT Angiography. That study showed that a low-dose CT angiography using only 2.6 milliseverts (mSv) of radiation was as accurate as catheter angiography. That compares to a conventional dose CT angiography of 12 mSv.

Such studies demonstrate the commitment of those in the radiology and imaging professions to providing patients with the safest, lowest radiation dose possible for their screening, diagnostic and treatment needs. At the Radiation Dose Summit, radiology and imaging professionals met at the National Institutes of Health in Bethesda, Maryland on Feb. 24 to discuss strategies for further reducing radiation dose in computerized tomography.

The National Institutes of Health and the Coalition for Imaging and Bioengineering Research (CIBR) sponsored the meeting with support from the FDA, the American College of Radiology (ACR), and American College of Cardiology (ACC). A specific goal of the conference was to identify the technological steps and associated research required to reduce routine CT exam doses to less than one millisievert (mSv) and to set policies for medical radiation technology and care.

Setting the tone for the conference, Dr. John A. Patti, chair of the American College of Radiology Board of Chancellors, called for the government, manufacturers and imaging providers to work together to arrive at quality-based imaging utilization and safety policies to ensure that patients get safe, quality care.

“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,” Patti said in a prepared statement;  “and when imaging is appropriate, that those we care for receive the right exam for the right indication at the right time.”

Two of the steps the ACR has taken in recent years are the CT Dose Index Registry and the ACR Appropriateness Criteria®. The index registry allows facilities to submit anonymous patient dose information for each CT exam and compare their doses against national benchmarks. The system provides ongoing feedback and sends alerts when certain dose levels are exceeded to help providers ensure that, over the long-term, patients receive the optimal dose.

The ACR Appropriateness Criteria provides standards for clinical decision support systems (CDS). These systems are designed to aid providers in prescribing the most appropriate scan for the patient’s condition, and reducing unnecessary exams.

Other examples of efforts to reduce medical radiation exposure are the Image Gently, and the Pause & Pulse campaigns, which are joint efforts of the ACR, the Radiological Society of North America, the Society for Pediatric Radiology, the American Association of Physicists in Medicine, and the American Society of Radiologic Technologists. The aim is to raise awareness across disciplines about unnecessary radiation scans and use of the lowest optimal radiation dose involving 60 medical societies and 700,000 medical professionals worldwide.

“The ACR continues to work on a number of fronts to improve and maintain the quality of care that our patients receive,” said Patti. “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.”

By: Michael O'Leary, contributing editor Health Imaging Hub


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