Resources For Reducing Radiation Exposure From CT Scans And Other Imaging Procedures

The first two articles in Resources (1 and 2) will be useful for clinicians.

Resource (3) is a great article on radiation risk from medical imaging for patients. It is brief and accurate.

Resource (4), Image Gently, is for parents and physicians, to help us reduce radiation exposure in pediatric imaging. There are two excellent microsites: www.imagegentlyparents.org and www.imagegentlyproviders.org

Resource (5), Imaging Wisely – Radiation Safety In Adult Medical Imaging, from the American College Of Radiology is useful for patients and clinicians.

Resource (6) is helpful for clinicians. It has recommendations on imaging for ten clinical scenarios from the American College of Radiology.

Some of the scenarios emphasize decreasing radiation exposure by reducing unhelpful medical imaging through appropriate clinical risk stratification. For example:

Don’t image for suspected pulmonary embolism (PE) without moderate or high pre-test probability of PE.

Other scenarios emphasize ways to reduce radiation exposure through ordering the correct imaging study. For example:

Don’t use a protocol for abdominal CT that includes unenhanced CT followed by IV contrast-enhanced CT, except for the following indications: renal lesion characterization, hematuria work up, indeterminate adrenal nodule characterization, follow-up after endovascular stent repair, gastrointestinal hemorrhage or characterizing a focal liver mass.

Resource (7), XrayRisk.com, is an excellent site for physicians and patients.

The Frequently Asked Questions (faq) page has a complete set of answers to patients radiation safety questions.

There is a risk calculator which helps patients understand the radiation safety issues for the medical imaging procedure that the physician recommends.

Resources (8) is another radiation risk calculator.

Resources (9 and 10) will likely be of interest only to some clinicians.

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Resources:

(1) Communicating radiation risk to patients and referring physicians in the emergency department setting [PubMed Abstract] [Full Text HTML] [Full Text PDF]. Br J Radiol. 2016;89(1061):20150868. doi: 10.1259/bjr.20150868. Epub 2016 Jan 11.

(2) Radiation Risk From Medical Imaging [PubMed Abstract] [Full Text HTML] [Full Text PDF]. Mayo Clin Proc. 2010 Dec; 85(12): 1142–1146.

(3) Radiation risk from medical imaging from Harvard Health Publishing, Updated: April 2, 2018 Published: October, 2010.

(4) Image Gently – The Image Gently Alliance:

The mission of the Image Gently Alliance is, through advocacy, to improve safe and effective imaging care of children worldwide.

The Image Gently Alliance is a coalition of health care organizations dedicated to providing safe, high quality pediatric imaging worldwide.  The primary objective of the Alliance is to raise awareness in the imaging community of the need to adjust radiation dose when imaging children.  The ultimate goal of the Alliance is to change practice.

The Image Gently Alliance began as a committee within the Society for Pediatric Radiology in late 2006. In 2007, The SPR leadership reached out to friends and colleagues in sister societies representing the key members of the imaging team, ACR, ASRT and AAPM, to form “the Writers Group.” These organizations developed the concept of the Alliance and their representatives developed the campaign in the summer of 2007.

The organization has developed a transformative group of campaigns to address digital radiography, fluoroscopy, interventional radiology, nuclear medicine, computed tomography, dentistry, cardiac imaging and imaging in the setting of minor head trauma.  Targeted information is also now available on two new microsites:

www.imagegentlyparents.org and www.imagegentlyproviders.org

Image Gently, the first in a now world-wide network of campaign partners, has become a recognized presence at both national and international venues.

(5) Image Wisely – Radiation Safey In Adult Medical Imaging From The American College of Radiology

(6) Ten Things [Regarding Medical Imaging Procedures] Physicians and Patients Should Question from The American College of Radiology Choose Wisely Campaign. Released April 4, 2012 (1-5) and October 16, 2017 (6-10); sources for #1, 2, 3 and 5 updated June 29, 2017

(7) xrayrisk.com – Promoting responsible imaging through patient and provider education

(8) Radiation Risk Calculator

(9) The Basics of Radiation Dose Monitoring in Medical Imaging from Imaging Technology News, Sept 08, 2017

This article originally ran as an introduction to the Radiation Dose Management comparison chart in the September 2017 issue. The chart can be viewed here.

(10) Monitoring Radiation from Imaging Technology News, April 1, 2015

New metrics and methods are helping radiologists keep dose down and share their successes with peers

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