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NorthSide Reaction

Addressing the radiation exposure question

Diagnostic tests such as CT scans have the power to help physicians diagnose a variety of health conditions. But they also pose a health risk in the form of radiation exposure.

After years of acclaim as a “miracle” technology which revolutionized internal medicine, in December 2009, the Archives of Internal Medicine published a study presenting the radiation exposure risks of overusing CT tests. These findings made physicians and patients alike rethink how this test was being used, and since then the question of radiation exposure and patient safety has appeared regularly in national news, including this recent article from the Associated Press.

“Of the many ways Americans are overtested and overtreated, imaging is one of the most common and insidious. CT scans - 'super X-rays' that give fast, extremely detailed images - have soared in use over the last decade..."

Dr. Adam Finkelstein, a diagnostic radiology specialist at Swedish Covenant Hospital, said it is appropriate to be concerned about unnecessary imaging.

Physicians have long employed the As Low As Reasonably Achievable, or ALARA, principle when weighing the benefits of using CT scans to diagnose disease against the risks of radiation exposure associated with the test, and the finding on CT radiation were a perfect example of why this scrutiny is so important. Many factors go into the decision to use a CT test, and it is always made on a case-by-case basis with the intent of providing the most good to the patient. In many patient cases, radiation-free methods can effectively diagnose disease, but in many others, CT offers the least invasive and most accurate option, Finkelstein said.

The December study and recent news have further defined the extent of radiation exposure involved with CTs and the need for weighing these factors even more carefully, and Finkelstein has already seen improved awareness among physicians and patients since the publication of this study and news.

“CT is an extremely valuable test when used appropriately. Problems with radiation arise when the test is overused,” Finkelstein said. “As awareness has increased about radiation risks in CT, there has been a healthy nationwide pull-back in unnecessary usage, as well as a push to develop and implement new technologies which minimize radiation exposure.”

One example of this “new technology” is the Definition Flash CT scanner now in use at Swedish Covenant Hospital. This new technology works four times faster than any previous CT, which means patients receive the lowest doses of radiation available. These technological advances, combined with a staff that understands when it is appropriate to administer a test, means better, safer tests for patients, Finkelstein said.

“As a patient you can take solace in that when used appropriately, the latest CT technology exposes patients to less radiation and is a valuable tool which is far more likely to detect a problem than cause one,” Finkelstein said. “When used appropriately, the benefits outweigh the risks dramatically.”

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