Overview
For a number of contributing reasons and with the advent of multi-slice CT, medical imaging experienced runaway growth thru the 1990s and 2000s. This unbridled escalation in utilization eventually spurred efforts in the industry and governmental initiatives to address concerns regarding increased patient radiation exposures. By 2015 concerns of over exposure to radiation from medical imaging reached a fever pitch in the mainstream (legacy) media. Five years later, COVID triggered a significant decrease in utilization. Some statistical data suggests radiation exposure from medical imaging to the general public dropped in excess of 50% during 2020. By 2022 volumes rebounded and were again on the increase. Although the growth in the last decade has flattened in mammography and sonography and indeed declined in some areas such as general diagnostic x-ray, demand for advanced technologies associated with higher patient radiation exposures such as CT, nuclear medicine, interventional radiology, and PET imaging continue to show trends of increasing utilization. Technological advances in the development and manufacture of imaging equipment continue to deliver lower doses and yet utilization concerns raised in the previous decade remain highly relevant in the imaging field today and into the future.
It should be noted, in 2007 widespread concerns similar to those conveyed in the media gave birth to the radiation patient advocacy movement within the industry. Although we will examine radiation exposures from various imaging modalities, we begin with Computed Tomography (CAT Scan) the largest single contributor to patients’ exposure to radiation from medical imaging.
Reliable sources for information are difficult to find.
Although we will usually use what are considered scholarly resources in discussions, it is evident that some scientific journals and even academia have become bias and contain misinformation. The untoward influence of money from various entities such as “Big Pharma” and other related actors have created a research funding structure (strings attached) which has compromised the integrity of scientific publications.
All sources must be critically evaluated. This week readings come from a source sponsored by the American College of Radiology (ACR), a professional medical society, the other is a peer reviewed medical journal. A word of caution, even a professional society/journal may be prone to bias in the interest of their stakeholders. Organizations that derive income from imaging tend to use “soft pedal” language regarding radiation exposure and CT utilization even when accurate information is presented, it is often in a toned-down manner. For example, estimates from various sources suggest 5%-50% of CAT scans performed annually are considered unwarranted. Entities that derive income from imaging or are aligned with the imaging industry tend to focus and interpret the data that support the lower end of the range while watch dogs and payors like Medicare tend to focus on the higher estimates of unjustified imaging. We start out simple, and as we progress we will dig deeper with comparisons, contrasts, analysis … for now let’s establish a baseline. Please share how the information from these sources impacted you personally. Is the information contained in these articles common knowledge? Were you well aware of modern dose trends? How do you reconcile and process this information.
Check out the 2 links below for this week's discussion before making your posts to the forum.
You must post a response to the discussion question(s). Your initial post must be completed each week by Wednesday at 11:59pm. No more than two (2) posts for credit on any given day. Postings should be a minimum of 3-5 sentences and a maximum of two paragraphs.
Is diagnostic medical radiation safe? 2024Projected Lifetime Cancer Risks From Current Computed Tomography Imaging | Less is More | JAMA Internal Medicine | JAMA Network 2025