Radiologists call for curbs on overuse of imaging technology

Radiologists call for curbs on overuse of imaging technology

Less the better

Radiologists call for curbs on overuse of imaging technology

Suzanne Sloan, a teacher, suffered hair loss after receiving a CT perfusion scan at a hospital in Huntsville. NYT

She considers the patient’s total past exposure, and then carefully weighs the risks and benefits of each test and any alternative approaches she can take.

Two new studies suggest more physicians should take this approach. One study found that certain nuclear-based breast imaging exams that involve injecting radioactive material into patients expose women to far higher doses of radiation than regular mammography, increasing their risk of cancer in vulnerable organs beyond the breast.

“I’m a radiation phobe — I’ll come right out and say this,” said Rhodes, an internist at the Mayo Clinic. “I’m constantly monitoring radiation doses in my patients.” R Edward Hendrick, another physicist said he was motivated to quantify the radiation exposure from nuclear breast imaging technologies in a published paper because of similar concerns.

Nucleaur technologies

The nuclear technologies breast-specific gamma imaging (B S G I) and positron emission mammography  (P E M) are meant to be used as complements or adjuncts to mammography and ultrasound, once there is concern about a cancerous lesion, and not for routine screening.

These technologies are also more useful in women who have very dense breast tissue, when mammography often does not provide clear images.

But a single breast-specific gamma imaging or positron emission mammography exam exposes patients to a risk of radiation-induced cancer that is comparable to the risk from an entire lifetime of yearly mammograms starting at 40, according to Hendrick’s study.

There is also a concern that use of the imaging technologies will become more widespread and casual. Suggested proposals for curbing excessive use of imaging include developing national evidence-based appropriateness criteria for imaging, educating referring physicians and the public, curbing the physician practice of self-referral and finding ways to reduce duplicate exams.

Companies that make the two nuclear-based breast imaging exams did not argue with the assessment of radiation exposure, but said the comparison with mammography  was inappropriate because the tests are used differently.

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