Recently the Food and Drug Administration announced that officials are looking into possible steps requiring device makers to print the radiation dose on each X-ray or other images so patients and doctors can see how much was given.
This action is in response to numerous medical studies showing that Americans are getting too much radiation and unnecessary treatments and tests. Currently, doctors have no way of tracking how much radiation patients receive and except for mammograms, there are no federal rules on radiation doses. Children and young women, who are most vulnerable for radiation harm, sometimes get too much at busy imaging centers that don’t adjust doses for each patient’s size.
The aim of the FDA’s actions are to “help reduce unnecessary patient exposure to ionizing radiation during these procedures,” the FDA said in announcing its recent meetings on radiation and exposure. According to the New England Journal of Medicine, the imaging techniques from CT scans and fluoroscopy’s are two of the top three contributors to total radiation exposure among Americans. The FDA sites that use of these imaging techniques have much higher radiation doses than standard X-rays, dental X-rays and mammography, potentially increasing the lifetime risk for cancer.
Dr. Jorge Guerra, Jr., professor of radiology at the University Of Miami Miller School Of Medicine, agreed that manufacturers need to “give us the best equipment and teach us how to use it properly,” says Dr. Guerra. “It’s the overuse of CT scans that’s really the problem. There needs to be clearer guidelines for the use of CT scans and other radiological devices, including specific criteria on who should be getting scans for what particular conditions,” concluded Dr. Guerra.
The U.S. National Cancer Institute reports about 70 million CT scans are now done in the United States each year. In the early 1980’s, the report shows that only 3 million were done annually. The Institute also estimates that up to 14,000 people die each year from radiation-induced cancers. Studies show that 20 million adults and more than 1 million children are needlessly being put at risk with unnecessary CT scans.
The reasons for overuse; accuracy and ease. Scans have become a crutch for doctors afraid of using exams and judgment to make a diagnosis. Dr. Richard Baron, a primary care doctor in Philadelphia says that, “Some think a picture tells more than it does. Imaging that shows arthritis in a knee or back problems doesn’t reveal how to make it better, says Dr. Baron. “Physical therapy for an orthopedic injury is always the first choice,” advices Dr. Baron. “Yet most doctors rush to order tests. The question you should be asking when you do sophisticated imaging is ‘Is there something I can fix with an operation?’”
Malpractice fears, patient pressure, insurance issues, availability and treatment choices are also reasons for the large number of radiation treatments. A quick fix for chest pain is artery-opening angioplasty- which requires far more imaging and radiation than bypass surgery does, and the same holds true for virtual colonoscopies instead of standard ones. In May 2010, federal officials decided that Medicare should not cover virtual colonoscopies when they weighed the medical benefits against potential risk, including radiation exposure.
The FDA noted that the benefits of medical imaging were considerable because they have led to diseases being diagnosed earlier; however, they are working to keep radiation exposure to a minimum and avoid unnecessary testing. The FDA actually warns against full-body scans for patients who have no symptoms. It says the risks related to radiation and unnecessary follow-up tests outweigh any potential benefits.
But even when tests are justified, they often include more views than needed and too much radiation. The top offender for radiation over-exposure according to physicians is chest CT scans looking for clogged arteries and heart problems. At Columbia University, researchers found that modifying techniques for CT scans could lower the needed radiation dose by 90 percent without harming image quality.
So before you rush and get a radiation treatment, ask your doctor questions about what’s the dose, and why am I getting it. You should also be cautious of CT scans that deliver a lot of radiation to the chest and abdomen, places where cancer is likely to develop. Being an informed patient is your best defense to avoid overexposure to radiation treatments.