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Greg Cusimano
Greg Cusimano
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Have You Had a CT Scan Lately?

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Have you had a CT scan lately? They are commonplace in medicine today. These sophisticated X-Rays have been beneficial in diagnosing illnesses. Are the benefits worth the risk? 29,000 people will likely get cancer as a result of the CT scans they had in 2007 according to a study by the National Cancer Institute and other research.www.npr.org/templates/story/story.php Dr Rita F. Redberg publishing the research has called it a "Public Health time bomb". The FDA is investigating the dosages in hospitals in California and in Huntsville, Alabama.

The Archives of Internal Medicine in the Dec. 14th edition reports that routine “CT scans are exposing patients to far more radiation than previously thought and … could cause tens of thousands of cancers a year….”

The symptoms of over exposure depends on how much radiation you have absorbed. The exposure level depends on the distance between you and the source of the radiation and the strength of the radiated energy. The initial signs may be nausea and vomiting, and how quickly you show symptoms from the time of the exposure is a fairly reliable indicator of the overexposure.health.msn.com/health-topics/cancer/articlepage.aspx

A proper exposure from a necessary CT scan should be a low dose and cause no problems. The doctor and technician should be aware of the exposure. There has been some concern that the CT scanners in the particular hospitals under investigation in CA and AL may be defective.

Talk to your doctor – but do not refuse a scan if it is needed. It is all about risk vs. benefits, but don’t be afraid to ask questions.

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    Media coverage of the two recent studies published in the Archives of Internal Medicine, claiming increases in cancer due to use of computed tomography (CT), raises vital public policy issues that must be considered.

    First, it’s important to understand that medical imaging manufacturers have made incredible strides in innovating advanced equipment that minimizes radiation dose. In fact, new medical imaging technologies and systems introduced during the past 20 years have significantly reduced radiation dose.

    Even with this progress, manufactures continuously explore the next frontiers of innovative medical imaging technology that will exponentially reduce radiation exposure while exponentially increasing the capability and quality of the images it delivers — allowing physicians to save more lives. To that end, we believe policymakers should encourage technologic development so that companies can continue to innovate and produce diagnostic equipment that reduces radiation dose and improves patient outcomes.

    Next, while nobody disputes the effectiveness of CT scans, the assertion that CT scans are overused is an outdated perception. In fact, an analysis of Medicare claims data from 1998-2007 demonstrates that beginning in 2007, spending on advanced diagnostic equipment decreased by 19.2 percent while volume grew by a modest 1.9 percent. Any claims that the use of CT is rapidly growing is false.

    Imaging manufacturers believe that they way to continue driving proper use of CT, as well as other diagnostic equipment, is to ensure physicians have access to, and are relying on, evidenced-based guidelines at the point of care to determine which diagnostic test should be ordered (or not ordered). That’s why MITA strongly endorses a robust build-out of appropriateness criteria in the Medicare program. and research supports this approach. This is the best way to drive proper utilization while ensuring patients have access to the diagnostic procedures they need.

    Lastly, it’s important to point out that medical imaging, when used appropriately, minimizes other risks that more invasive procedures present to patients, and enables doctors and patients to more effectively tackle the very real and very deadly diseases they already have. We must preserve access to these scans while smartly fostering the development of new technologies and ensuring their proper use.

    Dave Fisher
    Managing Director
    Medical Imaging & Technology Alliance (MITA)

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    See this article about the Huntsville problem. http://www.whnt.com/news/whnt-huntsville-hospital-responds-to-radiation,0,859454.story

    “”We’re definitely doing too many procedures,” said Dr. Howard Forman, Professor of Radiology at Yale School of Medicine. “Every time we work in the ER or in the in-patient setting, after the fact, it becomes very obvious that certain studies either could’ve been avoided, delayed or not done at all.”

    This was a post earlier concerning a CA hospital. I can’t vouch for its’ accuracy, but reflects a real concern.
    “Cedars-Sinai Hospital Under Investigation for Radiation Overdoses of 206 Patients
    OCTOBER 10, 2009 – The U.S. Food and Drug Administration (FDA) issued a warning yesterday regarding the risks of overexposure to radiation during CT scan procedures. The warning came after officials determined a CT brain scan machine at Cedars-Sinai Medical Center was set to an unsafe level– exposing 206 patients to eight times the dose of radiation normally delivered in the CT scan procedure. The overdoses were delivered to patients undergoing CT brain perfusion scans – to aid in the diagnosis and treatment of stroke. According to the FDA, instead of patients receiving 0.5 Gy (gray) to the head, the patients received 3-4 Gy.
    In their alert issued on October 9, 2009, the FDA did not specifically identify Cedars-Sinai as the facility where the radiation overdoses occurred, but health officials at the Los Angeles hospital confirmed the situation to local news sources on Friday afternoon. The error at Cedars-Sinai went undetected for 18 months. Health officials became aware of the radiation overdoses in August. According to a hospital spokesman, about 40% of the 206 patients affected – roughly 80 people- lost patches of hair. Hair loss, however, is not the only concerning side effect of radiation overdoses. Very high doses of radiation can cause radiation poisoning and lead to cancer years or even decades later.“