Category Archives: Medical Tests
Between 1996 and 2010 the number of CT scans performed across the United States tripled (Dr. Smith-Bindman’s study looked at data on patients who had imaging among one million to two million patients a year from 1996 to 2010 in six health maintenance organizations ) This was thought to result from increased improvement and accessibility to the technology as well as avoidance of medical law suits.
As ionizing radiation is cumulative patients need to be warned of this and life-time amounts tracked. The scans can be very useful diagnostically but who is told for example that the angiogram their doctor orders is equivalent to 800 chest x-rays?
We know from all the data we have today that 2%-3% of cancers in this country are related to use of medical imaging and ionized radiation.
So, why don’t we tell patients when they have a particular imaging scan exactly how many millisievert (mSv) they’re getting exposed to? A CT angiogram of the heart is 16 mSv; a lot is being done to try to reduce that, but that is equivalent to 800 chest x-rays. How about a typical nuclear scan? A lot of patients who are treated in cardiology get this done every year. At 41 mSv, it’s equivalent to 2000 chest x-rays. But patients aren’t told any of this. And not only that, but we could actually measure exactly how many mSv they got by using the same type of radiation badges that the medical professionals use when they work in a cardiac cath lab or in an x-ray suite. But we don’t do that. This is a serious breach of our responsibility to patients.
We have a very important problem here with this runaway use of radiation procedures but no accountability with respect to patients’ exposure. This has come to a crisis point in children. Children who have a diagnosis of a pediatric malignancy, for example, go through all sorts of radiation imaging, and there have been clear-cut trends that this is increasing. It’s worrisome and, in fact, it could even engender additional problems in children burdened with cancer. We really need to change this.
In a digital world, this information could be collected from birth. Every individual should have their mSv exposure through medical imaging recorded cumulatively throughout their life and added to their electronic health record. Hopefully we’ll see that change come about in the future. This is something that’s a big hole in the current way that we work in medicine.