Pharmacy News EU

July 04BEHOLD COMPUTERIZED TOMOGRAPHY IMAGING aka the CT or CAT scan a technology so revolutionary that it helped earn its inventors a Nobel Prize in 1979.
The CT scan does what conventional X-ray technology can’t do: create a 3-D image to provide doctors with a more detailed picture of problems inside the body, from broken bones to tumors to blockages.
But CT technology also comes with a major downside. Compared with a conventional X-ray, it exposes patients to a supersized dose of radiation 50 to 500 times more which health experts believe translates into a higher risk for cancer over time. Just how big of a risk is debatable. In one study, published in the December 2009 issue of Archives of Internal Medicine, researchers estimated that 29,000 future cancers could be tied to CT scans performed in the U.S. in 2007 alone.
Few in the medical community, however, seem willing to ditch CT because it’s so useful. Instead, they’re stepping up measures to reduce the amount of radiation produced by a CT scan, use the technology more sparingly especially on children and follow imaging industry protocols to keep exposure as low as possible without compromising image quality.
It’s one reason Penrose-St. Francis Health Services recently invested $750,000 in software that can reduce radiation exposure by up to 40 percent during a CT scan, said Dr. Eric Weidman, a radiologist.
"There’s no magic bullet, but we want to minimize radiation exposure, yet get a good diagnostic image," Weidman said. "We’ve gotten it down by 30 percent since before we had the software; our goal is to get it down to 40 percent across the board."
Penrose-St. Francis and radiologists at Memorial Health System also are on board with a program called Image Gently, an initiative to reduce radiation exposure in pediatric patients through the use of CT scans and other imaging procedures that produce radiation, such as fluoroscopy and nuclear medicine studies.
"A big part of that we changed protocols we were using on children," said Scott Smith, radiology educator for Memorial. "We eliminated a lot of studies and parts of studies, and made them shorter. We changed the amount we used so that it was weight-based."
Memorial also hired a pediatric radiologist, and kids undergoing a scan are immobilized to limit movement, which reduces the need for a retake.
The lessons learned through Image Gently have spilled over into Memorial’s scans on adult patients, Smith said, so for example, smaller adults now get smaller amounts of radiation.
"We’ve been revising all protocols to address patient size," Smith said.
PENRAD Imaging of Colorado Springs, a freestanding imaging clinic with five offices, also uses Image Gently protocols and dose-reduction software, doles out doses based on weight and age, and evaluates the tests that doctors order to see how radiation exposure might be reduced.
"I think the No. 1 thing we do is to make sure the studies we do are appropriate," said Susan Bell-Smith, PENRAD’s vice president of marketing and contracting. "If a CT scan is ordered with and without contrast, for example, and our radiologist feels the patient needs only the one with contrast, we’ll call the referring doctor’s office to say there’s no need to additionally radiate this person particularly with CT scans."
The need to address radiation exposure from CT scans has gained momentum in the last few years from a variety of professional organizations and the federal government. In February, the U.S. Food and Drug Administration announced an initiative to reduce radiation exposure from imaging procedures, laying out recommendations that local hospitals and imaging centers already seem to be providing. The FDA says there needs to be justification for each procedure, and protocols in place to ensure that patients get the right exam with the right dose.
Despite the steps being taken to reduce exposure to radiation, some medical professionals believe more needs to be done. Dr. Rebecca Smith-Bindman, a visiting radiologist with the National Cancer Institute, has said CT scans are overprescribed, and she and a team of researchers recently issued a study concluding there is no standardization in using the equipment.
"Radiation doses from commonly performed diagnostic CT examinations are higher and more variable than generally quoted, highlighting the need for greater standardization across institutions," the researchers wrote.
No matter how much progress is made with radiation emitted in the medical world, there’s no way to escape it in the real world especially in high-altitude states like Colorado.
"There’s natural radiation from the sun and radon," Weidman said. "In Colorado Springs, we get three times the background radiation of someone at sea level."
All the more reason to seek out low-dose X-ray technology, medical professionals say.
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Copyright (c) 2010, The Gazette, Colorado Springs, Colo.
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