Medical radiation: Weighing the risks and benefits

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A frequent theme at this year's annual meeting of the Radiological Society of North America was that radiology must deal with threats to the future of the imaging industry. One such issue that has received plenty of media attention over the last several years: radiation doses.

Radiation "phobia" is "just one more stick on a pile of twigs" that represents the challenges faced by the radiology professionals, Bruce Hillman, M.D., professor of radiology and medical imaging and public health sciences at the University of Virginia School of Medicine, told FierceMedicalImaging in an exclusive interview. "But [the fear of radiation] has a meaningful effect, particularly since it's often irrationally applied."

For example, Hillman says, we really shouldn't be worrying about a 70-year-old man who has a CT scan every three months to follow his cancer. "He's not going to get a cancer from CT radiation," Hillman said. "But he may need that CT scan. We need to be more rational."

In a recent article in Diagnostic Imaging, Cynthia McCollough, Ph.D., of the Mayo Clinic in Minneapolis, said that anxiety about medical radiation is often exacerbated when the issue gets heavily publicized in the media. In that kind of environment, she said, her practice will see a number of canceled CT appointments.

Now radiologists are thinking about ways they can push back. In the same article McCollough talked about the need for open communication between physicians and patients so that they understand the potential benefits of CT weighed against the risk of radiation. "The evidence of any risk associated with CT exposure is and will remain controversial and will be debated for a long time," McCollough said. "But we can't continue to discuss small, hypothetical risks without emphasizing the large set of documentation that outlines CT's benefits."

ImageWisely.org makes the same point in its white paper on understanding and communicating radiation risk. While it's clear that the risk associated with the utilization of radiation may not be well understood at the levels at which it is used for diagnostic and interventional procedures, the risks of not performing an exam because of a fear of radiation could include missing a diagnosis or starting treatment too late to improve a medical outcome.

It is important that radiologists help patients understand the potential risks associated with radiation. It's also important that radiologists make it clear that in many cases the benefits or potential benefits associated with the use of radiation are far greater than any potential harm. And shouldn't that be the bottom line? Mike @FierceHealthIT