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How is Radiation Exposure Managed During Exams?

What is the radiology community doing to appropriately manage radiation exposure during exams?

Medical imaging and radiation therapy professionals recognize the importance of keeping the radiation dose to their patients as low as necessary while still using an adequate amount to ensure they obtain a diagnostic quality image. Certified radiologic technologists, nuclear medicine technologists and radiation therapists receive extensive education in radiation safety and protection during their education, and they are tested on these subjects during their certification examinations. There is also a Dose Index Registry available to CT facilities nationwide. It is a repository of dose-related information that can provide facilities a mechanism for comparing their exams to those of other facilities, nationally, regionally and locally. By comparing themselves to others, facilities can determine if the radiation dose from their procedures is within appropriate ranges.

What organizations play a role in radiation safety?

Furthermore, The American Board of Radiology requires that certified radiologists be familiar with radiation safety issues. Radiation management is a component of their board certifying examinations. The board has also included a similar section in the maintenance of certification criteria for radiologists who have been initially certified, and material includes opportunities for self-assessment as well as practicing quality improvement in radiation protection. This means that ongoing education in radiation management is required for board-certified medical imaging professionals.

How is the federal government involved?

The federal government, through agencies such as the U.S. Food and Drug Administration (FDA) and Centers for Medicare and Medicaid Services, has an impact on radiology safety by requiring safety features for equipment and facility accreditation for reimbursement. Radiologists and technologists, through their professional societies, cooperate with these agencies in their efforts. The FDA is launching a collaborative initiative to reduce unnecessary radiation exposure from medical imaging with a focus on the types of imaging procedures that are associated with the highest radiation doses such as CT scans, fluoroscopy and nuclear medicine.

Maintaining image quality while minimizing risks

The goal of these efforts is to support the benefits associated with medical imaging while minimizing the risks. In addition, many states that license medical imaging professionals require them to earn continuing education credits in radiation safety topics. The concept of minimizing radiation exposure to patients, themselves and others has become standard practice in the practice of radiology. The radiology community is increasingly aware of how much radiation a patient receives during each examination and cumulatively over several examinations. They are able to record the amount of radiation that is typically absorbed during each procedure. However, if proper precautions are not taken, patients may be exposed to radiation without clinical need or benefit.

Unnecessary radiation exposure may result from the use of a radiation dose above what is optimal to meet the clinical need in a given procedure. To a point, using a higher radiation dose can produce a higher resolution image. If the dose is too low, the quality of the resulting image may be poor, and, as a result, a physician may not be able to make an accurate clinical determination. An optimal radiation dose is one that is as low as reasonably achievable while maintaining sufficient image quality to meet the clinical need. Many facilities in the community use the latest equipment that provides the lowest dose and there is also new software and techniques that help minimize radiation exposure. Radiologists use ultrasound, MRI, and whatever other modalities they can when available in order to decrease lifetime exposure.