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Unindicated CT Series Result in Unnecessary Radiation Exposure for Patients
Date:11/29/2009

on for interpretation. The patients ranged in age from nine months to 91 years, with most between 30 and 50 years old.

There were a total of 978 series for the 500 patients. Using the American College of Radiology (ACR) Appropriateness Criteria®, 35.3 percent (345/978) of the CT series in 52.2 percent (261/500) of the patients were determined to be unindicated. The most common unnecessary exam was delayed-phase imaging, accounting for 268 (77.7 percent) of the 345 unnecessary series. In delayed-phase imaging, several images of the same region are obtained a short period of time after contrast injection to detect changes. Among the 500 patients, the mean excess radiation dose per patient from unnecessary scans was 11.3 millisieverts (mSv), equivalent to the dose received from 113 chest x-rays or three years of naturally occurring background radiation.

"We suspect that at many institutions there is a lack of focus on selecting CT protocols tailored specifically to answer the clinical question," said coauthor J. Louis Hinshaw, M.D., assistant professor of radiology at UW - Madison. "It is certainly easier to select an 'every size fits all' approach."

The researchers also noted a possible connection in some cases between additional scanning and increased payment, such as performing both non-contrast and contrast-enhanced scans when only one series was indicated.

Efforts are ongoing to protect patients from unnecessary radiation exposure from medical imaging procedures, including the Image Gently initiative for safety in pediatric radiology and an ACR-RSNA task force for adult radiation protection. In addition to following strict appropriate imaging utilization standards, radiologists and medical physicists stress the importance of minimizing dose without sacrificing diagnostic ability. Advances in CT technology over recent years have markedly decreased dose while maintaining optimal image quality.

Dr. Guite adv
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SOURCE Radiological Society of North America (RSNA)
Copyright©2009 PR Newswire.
All rights reserved

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