Since Cedars-Sinai infamously gave patients eight times the normal amount of radiation during CT scans over an 18-month period beginning in 2008, hospitals have tightened their protocols aimed at reducing patient radiation. Radiologists say limiting unnecessary radiation has always been their top priority, but now they are increasing efforts to prevent unintentional radiation overdoses.
“With the growing public health issues around the increasing use of ionizing radiation over the last five years in particular, we have amped up our efforts because we’re using radiation more,” says Steven Seltzer, MD, chairman of the department of radiology at Brigham and Women’s Hospital in Boston. “We feel it’s incumbent on us to take steps to reduce the amount of radiation we use in a given study, and we have to be more critical about how many studies we do.”
Radiology societies are also launching efforts to help providers monitor radiation dosing. Four radiology associations formed the Image Gently Alliance, which aims to raise awareness in the imaging community of the need to adjust the radiation dose when imaging children. The American College of Radiology also formed Image Wisely, a similar organization geared toward adult imaging.
First defense: Education
Both associations offer protocols and best practices for radiologists. These educational elements are critical to reducing radiation, says John Weaver, PhD, professor of radiology at Dartmouth Medical School and director of clinical physics at Dartmouth-Hitchcock Medical Center, which is working to bring the organization in line with Image Gently guidelines.
“Training is not very glamorous, but it’s certainly important to have well-trained people doing these scans,” he says.
Technologist training is the most important step to ensure patients receive the lowest radiation dose possible says, Anand Lalaji, MD, chairman and CEO of the Radiology Group in Atlanta. His company works to train all CT-scan staff at the health systems they serve.
“We are not allowing any technologist or any personnel that’s not a radiologist to change protocol unless it’s approved by the radiologist,” he says. “That prevents mistakes, because they could change the setting on a study for a larger patient that requires more radiation, but who’s to say that they don’t change the setting back. We put a protocol in place where they go through checks and balances before they are able to change the settings.”