Imaging can be life-saving: Understand the radiation risks.

Radiation is emitted in various forms. Understandably, CT scan radiation “absorbs” the attention of the public and media. As explained: “X rays, γ rays, and neutron beams are considered ionizing radiation. Ionizing radiation may break molecules into pieces, creating ionic free radicals that can be very damaging to tissue.”

For this reason, it is imperative that the use of radiation is only by highly trained personnel and that the public is appropriately educated so that they understand their risks as it relates to their health care. 

People come in all different sizes, and CT scans are obtained of different areas of the body, so actual absorbed radiation doses vary. Unfortunately, there have also been examples of over-exposure of patients due to computer errors that resulted in some individuals being scanned multiple times over the usual amount. These errors must obviously be corrected. There is no excuse.

The good news, however, is that radiologists are focused on the issue of decreasing radiation dose. In fact, researchers at the University of California - Davis, suggested that CT scanners be made more uniform, allowing technologists to better control the radiation dose.

Through continued discussion and research, medical personnel and non-medical people alike must stay informed as to actual radiation risks. Possible risks should be discussed and understood in context and without emotional hype or political spin. If  health care personnel are well-informed, then the public and media will be better able to understand our message regarding this very important issue.

The message:

When needed, CT imaging is useful to your health. Judicious use of CT imaging is essential. The risk of cancer from imaging-related radiation, if used appropriately and only when necessary, is small. No cancers have been proven to be caused by CT imaging radiation exposure.

The Society of Interventional Radiology has previously formally presented written testimony to the Energy and Commerce Committee on “Medical Radiation: An Overview of the Issue.” Most of the time was spent discussing ways to prevent further radiation overexposure and the means by which such prevention should be accomplished.

The SIR also recently published a position statement on imaging-related radiation use, which appropriately concludes: “We recognize that the physician has a responsibility to advise patients of the potential risks of radiation in a particular procedure so they can be weighed against possible benefits. The best decisions can be achieved when an informed physician and patient work together as a team.”

One of the most important aspects of imaging-related radiation exposure is that patients and physicians balance the risks with the benefits. As an interventional radiologist, I discuss the risks and benefits of procedures daily with my patients.

For example, a lung biopsy carries the risks of bleeding, infection and pneumothorax (or collapse of the lung), in addition to a small amount of radiation exposure related to the CT imaging used to guide the needle. But the benefits, one would hope and assume, outweigh those risks and include obtaining a rapid diagnosis so that treatment can be initiated.

In the case of a person who suffers a car accident, the ER physician may request a full body CT scan to evaluate for potentially life-threatening injuries. 

The bottom line is that we weigh the risks and benefits of each decision. Medical imaging carries small but real risks related to ionizing radiatino exposure. But, the public and mainstream media should understand that health care personnel are interested mainly in ensuring the health and well-being of their patients.