Quality initiatives* radiation risk: what you should know to tell your patient.
ABSTRACT The steady increase in the number of radiologic procedures being performed is undeniably having a beneficial impact on healthcare. However, it is also becoming common practice to quantify the health detriment from radiation exposure by calculating the number of cancer-related deaths inferred from the effective dose delivered to a given patient population. The inference of a certain number of expected deaths from the effective dose is to be discouraged, but it remains important as a means of raising professional awareness of the danger associated with ionizing radiation. The risk associated with a radiologic examination appears to be rather low compared with the natural risk. However, any added risk, no matter how small, is unacceptable if it does not benefit the patient. The concept of diagnostic reference levels should be used to reduce variations in practice among institutions and to promote optimal dose indicator ranges for specific imaging protocols. In general, the basic principles of radiation protection (eg, justification and optimization of a procedure) need to be respected to help counteract the unjustified explosion in the number of procedures being performed.
Article: CT dose reduction in practice.[Show abstract] [Hide abstract]
ABSTRACT: Greater than 10% of diagnostic imaging studies performed in developed countries are CT examinations. In the United States, as many as 60 million CT studies are performed each year, up to 7 million of which are performed in pediatric patients. In the spirit of the ALARA principle, both adult and pediatric radiologists should strive to decrease pediatric radiation exposure whenever possible. This can be achieved by utilizing imaging studies that do not require the use of ionizing radiation, thus decreasing the number of CT studies performed. If a CT study is indicated, the delivered dose should be optimized to use the lowest possible dose level while still answering the clinical question.Pediatric Radiology 09/2011; 41 Suppl 2:488-92. · 1.57 Impact Factor
Article: Radiation risk from medical imaging.[Show abstract] [Hide abstract]
ABSTRACT: This review provides a practical overview of the excess cancer risks related to radiation from medical imaging. Primary care physicians should have a basic understanding of these risks. Because of recent attention to this issue, patients are more likely to express concerns over radiation risk. In addition, physicians can play a role in reducing radiation risk to their patients by considering these risks when making imaging referrals. This review provides a brief overview of the evidence pertaining to low-level radiation and excess cancer risks and addresses the radiation doses and risks from common medical imaging studies. Specific subsets of patients may be at greater risk from radiation exposure, and radiation risk should be considered carefully in these patients. Recent technical innovations have contributed to lowering the radiation dose from computed tomography, and the referring physician should be aware of these innovations in making imaging referrals.Mayo Clinic Proceedings 12/2010; 85(12):1142-6; quiz 1146. · 5.79 Impact Factor
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ABSTRACT: Computed tomographic (CT) pulmonary angiography (CTPA) has become the de facto clinical gold-standard for the diagnosis of pulmonary embolism (PE) due to its high sensitivity and specificity. Direct detection or exclusion of PE and diagnosis of various other diseases that mimic symptoms of PE can be accomplished in a single exam. In addition, CTPA allows rapid risk assessment by providing a number of predictive markers for accurate risk stratification and patient management. This article reviews the current role of routine CT techniques and recently introduced dual-energy CTPA for the diagnosis of PE as well as the role of CT for the assessment of right ventricular dysfunction in the setting of acute PE.Current Cardiovascular Imaging Reports 4(6).