Rita Redberg on Excess Use of Radiation Imaging Tests

Rita F. Redberg, MD


February 20, 2014

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More Regulation for CT Scanners

Hello. I'm Rita Redberg, Professor of Medicine and Director of Women's Cardiovascular Services at the University of California, San Francisco, Medical Center.

I recently wrote an editorial for the New York Times on the overuse of imaging with high-dose radiation -- CT scans in particular.[1] I believe it is contributing to our high cancer rates and will contribute even more in the future.

I wrote this editorial with my colleague in radiology at UCSF, Rebecca Smith-Bindman. We looked at the role of the US Food and Drug Administration (FDA), and we think the FDA has potential to do even more in reducing patient exposure to radiation. Currently, the FDA oversees the approval of scanners, but it doesn't have regulatory oversight for how they're used. We need clear standards published by professional radiology societies or such organizations as the Joint Commission or the FDA.

In order to be accredited for CT scans, hospitals and imaging clinics should be required to track the doses that they use, and ensure that they are truly as low as possible by comparing them with published guidelines.

In work that Rebecca Smith-Bindman and colleagues did that was published in the Archives of Internal Medicine a few years ago, they looked at the dosage for CT scans -- commonly used CT scans, such as chest, abdominal, and pelvic scans -- at various institutions around the Bay Area.[2] What they found was interesting and shocking, in that there is 10- to-30-fold, and sometimes up to 50-fold, variation in the amount of radiation from these same CT scans done at different institutions, and sometimes even at the same institution on different days.

What that really tells us is that there's great potential to reduce the radiation dose in commonly used CT scans just by paying more attention to the radiation dose. And that's something that the profession can certainly take leadership on.

There are already initiatives under way. The American College of Radiology has the Image Wisely Program, which is helping to reduce and use imaging more wisely, and their pediatrics Image Gently initiative.


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