Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Experts recommend closer scrutiny of radiation exposure from CT scans

29.11.2012
UC Davis radiology expert leads published review of radiation exposure risks from medical tests

Amid increasing fear of overexposure to radiation from CT scans, a panel of experts has recommended more research on the health effects of medical imaging and ways to reduce unnecessary CT tests, as well as industry standardization of CT machines.

The recommendations, published in the November 2012 issue of Radiology, were developed at the Radiation Dose Summit, organized by the National Institute of Biomedical Imaging and Bioengineering (NIBIB). The summit included more than 100 medical physicists, radiologists, cardiologists, engineers, industry representatives and patient advocates.

The proceedings, held in Bethesda, MD in early 2011, covered currently understood risks of radiation exposure from CT scans, set priorities for future research, and called for changes to industry practices.

"The number of CT exams in the U.S. has increased by about 10 percent each year over the past decade," said John Boone, UC Davis professor of radiology and lead author of the Radiology article. "This trend underscores the importance of developing a better understanding of the health risks of radiation exposure versus the benefits of enhanced diagnosis."

The experts conceded that despite widespread public concern about radiation risks, the biologic effects from medical imaging tests are not entirely understood. Most direct evidence comes from the effects of instantaneous, high-dose, whole-body exposures due to industrial accidents and from survivors of the atomic bombs in Hiroshima and Nagasaki, Japan. Whether these findings can be extrapolated to people exposed to occasional and much smaller dosages applied to only parts of the body is uncertain.

"The standards regarding 'safe levels' of radiation were designed for workplace safety and are very conservative," said Boone. "We don't know whether the established thresholds are really meaningful for exposure from medical testing."

The experts pointed out that because there is a high background incidence of cancer worldwide, the small incremental increase in cancer that may be attributable to low doses of radiation from medical imaging is extremely difficult to ascertain. They stated that national and international registries that track cancers and patient exposures to medical radiation may one day make it possible to conduct large epidemiological studies that could help make such associations.

"In reaction to media coverage of radiation overexposure cases, some patients refuse to undergo medical imaging procedures," said Boone. "Yet for almost all patients, the risks of foregoing a needed medical procedure far outweigh any potential radiation-associated risks."

Even accurately recording patient exposures of radiation from medical imaging is extremely difficult, according to the authors. Although it is easy to ascertain how much radiation a machine administers during an imaging study, the amount actually received by a patient depends on various factors including body size. For example, because of differences in body mass, children and small adults can receive a dose of radiation two to three times that of larger people, even when the dose administered is the same.

Other factors, such as whether the patient lies on a moving or stationary table, also affect the radiation dose received. Federally sponsored research is needed to develop methods to more accurately measure patient exposures from different types of CT scans, the authors suggested.

Summit participants also discussed the role of human error in CT scanning, which has resulted in widely publicized instances of radiation overexposure. They point out that CT operators frequently are responsible for several machines made by different manufacturers, each of which may utilize dissimilar nomenclature and control consoles, thereby increasing the chance for error.

"For some scanners, you turn a dial to the right to get a larger dose, and for others, turning it the same way gives a smaller dose," said Boone. "There are so many differences in current CT scanners, it can be like driving a car with the brake pedal on the left in the morning, then with the brake on the right in the afternoon."

CT scans should be built more like cars, he argued, which may have different exteriors, dashboards and seat coverings but are standardized across the industry so that they are driven the same way, making driving errors unlikely to occur when switching from one kind of car to another.

The experts call for academic and professional radiology societies, as well as industry trade organizations, to exert pressure on CT manufacturers to standardize nomenclature and control consoles to help avoid mistakes.

The experts also considered "wasteful imaging" ¯ tests that have little impact on patient diagnoses or outcomes ¯ resulting in unnecessary radiation exposures. Wasteful imaging can arise if physicians are unaware of a patient's prior tests or don't really know whether a scan will benefit a patient with certain signs and symptoms. In addition, physicians may order tests they know are only marginally useful to avoid accusations of negligence in a possible future lawsuit. The experts recommend use of information technology to develop national imaging and radiation exposure registries, as well as standardized protocols that guide physicians on the use of optimal imaging modalities for different clinical problems.

The University of California recently provided grants to all five of its medical schools to develop methods for more accurate measures of radiation exposure from CT scans and to build protocols that improve diagnostic information and reduce radiation risks. According to Boone, the tools under development are very powerful and will move the UC system toward achieving the goals outlined during the Radiation Dose Summit.

The article is titled, "Radiation exposure from CT scans: How to close our knowledge gaps, monitor and safeguard exposure ¯ proceedings and recommendations of the Radiation Dose Summit, sponsored by NIBIB, February 24-25, 2011."

The other authors of the article are Steven Seltzer of Brigham and Women's Hospital and Harvard Medical School in Boston, Mass., William Hendee, from the Medical College of Wisconsin in Milwaukee, and Michael McNitt-Gray from the David Geffen School of Medicine at UCLA.

UC Davis Comprehensive Cancer Center
UC Davis Comprehensive Cancer Center is the only National Cancer Institute-designated center serving the Central Valley and inland Northern California, a region of more than 6 million people. Its specialists provide compassionate, comprehensive care for more than 9,000 adults and children every year, and access to more than 150 clinical trials at any given time. Its innovative research program engages more than 280 scientists at UC Davis, Lawrence Livermore National Laboratory and Jackson Laboratory (JAX West), whose scientific partnerships advance discovery of new tools to diagnose and treat cancer. Through the Cancer Care Network, UC Davis collaborates with a number of hospitals and clinical centers throughout the Central Valley and Northern California regions to offer the latest cancer care. Its community-based outreach and education programs address disparities in cancer outcomes across diverse populations. For more information, visit cancer.ucdavis.edu.

Dorsey Griffith | EurekAlert!
Further information:
http://www.ucdmc.ucdavis.edu

More articles from Health and Medicine:

nachricht Norovirus evades immune system by hiding out in rare gut cells
12.10.2017 | University of Pennsylvania School of Medicine

nachricht Flexible sensors can detect movement in GI tract
11.10.2017 | Massachusetts Institute of Technology

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Breaking: the first light from two neutron stars merging

Seven new papers describe the first-ever detection of light from a gravitational wave source. The event, caused by two neutron stars colliding and merging together, was dubbed GW170817 because it sent ripples through space-time that reached Earth on 2017 August 17. Around the world, hundreds of excited astronomers mobilized quickly and were able to observe the event using numerous telescopes, providing a wealth of new data.

Previous detections of gravitational waves have all involved the merger of two black holes, a feat that won the 2017 Nobel Prize in Physics earlier this month....

Im Focus: Smart sensors for efficient processes

Material defects in end products can quickly result in failures in many areas of industry, and have a massive impact on the safe use of their products. This is why, in the field of quality assurance, intelligent, nondestructive sensor systems play a key role. They allow testing components and parts in a rapid and cost-efficient manner without destroying the actual product or changing its surface. Experts from the Fraunhofer IZFP in Saarbrücken will be presenting two exhibits at the Blechexpo in Stuttgart from 7–10 November 2017 that allow fast, reliable, and automated characterization of materials and detection of defects (Hall 5, Booth 5306).

When quality testing uses time-consuming destructive test methods, it can result in enormous costs due to damaging or destroying the products. And given that...

Im Focus: Cold molecules on collision course

Using a new cooling technique MPQ scientists succeed at observing collisions in a dense beam of cold and slow dipolar molecules.

How do chemical reactions proceed at extremely low temperatures? The answer requires the investigation of molecular samples that are cold, dense, and slow at...

Im Focus: Shrinking the proton again!

Scientists from the Max Planck Institute of Quantum Optics, using high precision laser spectroscopy of atomic hydrogen, confirm the surprisingly small value of the proton radius determined from muonic hydrogen.

It was one of the breakthroughs of the year 2010: Laser spectroscopy of muonic hydrogen resulted in a value for the proton charge radius that was significantly...

Im Focus: New nanomaterial can extract hydrogen fuel from seawater

Hybrid material converts more sunlight and can weather seawater's harsh conditions

It's possible to produce hydrogen to power fuel cells by extracting the gas from seawater, but the electricity required to do it makes the process costly. UCF...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ASEAN Member States discuss the future role of renewable energy

17.10.2017 | Event News

World Health Summit 2017: International experts set the course for the future of Global Health

10.10.2017 | Event News

Climate Engineering Conference 2017 Opens in Berlin

10.10.2017 | Event News

 
Latest News

Study suggests oysters offer hot spot for reducing nutrient pollution

17.10.2017 | Life Sciences

Breaking: the first light from two neutron stars merging

17.10.2017 | Physics and Astronomy

World first for reading digitally encoded synthetic molecules

17.10.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>