AHRA 2011: Wise Imaging Choices Key for Over-exposed Radiology Industry

GRAPEVINE, TX -The radiology industry finds itself dealing with exposure - not just in determining appropriate levels of radiation, but also with an overabundance of media coverage on the topic of dose.

"We are absolutely consumed by radiology dose," said Stewart C. Bushong, professor of radiologic science at Baylor College of Medicine in Houston, speaking at the AHRA annual conference this week.

The industry continues to learn how imaging procedures affect the human body, at a wide range of ages. But the industry, and media, should not obsess about exposure to an unreasonable, unhealthy degree, Bushong cautioned. Take airport scanners, for example. There's been a lot of news about radiation exposure in some scanners. But each individual visit through many scanners actually exposes a person to negligible levels of radiation, Bushong said. Though true potential for worry could come with the frequency of scans, he said, some reports have heavily hyped single-visit exposure.

A widespread national media frenzy years ago on CT research jump-started the industry's large-scale campaign to better grasp the body's reaction to imaging. The study by Columbia's David Brenner spotlighted children's sensitivity to radiation as the industry had not shown it before. It called into question issues of dose levels, and CT necessity.

"We've been doing this for 30 years," Bushong observed, "and you would've thought we'd know by now."

The flurry of news prompted even greater awareness of the effects of radiology and imaging services on the body, and its correlation to health problems, including cancer.

It's becoming increasing more important to monitor radiation's effects, as the sheer volume of imaging work - and therefore, patient exposure - has dramatically increased in the last decade. According to Bushong, since 1990, a person's overall exposure to radiation from medical imaging has jumped from 0.6 mSv to a 3.2 mSv.

Bushong said radiologists and technologists need to be keenly aware of the radiation a patient is receiving not just in one area of the body, but holistically. He noted new research is emerging trying to more accurately measure the extent of over-ranging, which could result in 30 percent to 40 percent more exposure to radiation than needed.

Bushong predicted some lingering concerns over radiation exposure will increase the popularity of emerging, presumably safer methods, like tomosynthesis. "My guess is, this [tomosynthesis] is going to prevail," he said.

He called for the industry to make wise imaging decisions by considering the appropriateness of each potential radiologic service. Appropriateness guidelines have become ever more important in the industry's evolving landscape. "Appropriateness is a big deal right now because of overutilization," Bushong said.

Signifying its importance, the industry has made making wise imaging choices easy and accessible, all from your smart phone. Got a concern over a particular treatment? There's an app for that.

It's become even more important to weigh the necessity of each service, as imaging costs have skyrocketed, especially as compared to other national spending trends. Inflation, for example, increases at a rate of 3 percent each year, Bushong noted. Health care costs jump roughly 9 percent.

Medical imaging has blown up at a whopping 18 percent.

That significant jump casts a greater spotlight on the industry, as federal penny-pinchers take aim at costly health care. It makes it that much more vital to ensure proper, safe dosing in providing imaging services, Bushong said.

While such attention and accountability are beneficial to diagnostic imaging and its patients, Bushong cautioned, it's important to keep things in some kind of perspective. A flood of studies, research and media reports have obsessed over the perils of over-exposure and how the industry has responded. What has been far less documented, Bushong said, has been research on just how many lives medical imaging has saved.