Cancer from CT Screenings?

(CBS)  A new study finds that radiation from the commonly perform CT scan are higher than generally thought, raising concerns about increased risk for cancer.

Scientist with the University of California, San Francisco (UCSF) found significant variation in the radiation doses for the same type of computed tomography procedures within institutions and across institutions, said lead investigator Rebecca Smith-Bindman, MD, a professor of radiology at UCSF. The results highlight the need for greater standardization because this is a medical safety issue."

Compared to other imaging procedures, the median effective dose delivered through a single CT scan was as high as 74 mammograms or 442 chest x-rays, according to Smith-Bindman.

The researchers identified three key practices necessary to improve the safety of CT procedures and the associated radiation doses:

Reduction of unnecessary studies and studies thought unlikely to influence clinical decisions.

Standardization and utilization of low-dose and lower-dose protocols for every CT scanner.

Standardization of radiation doses across patients and facilities through federal legislation and FDA oversight stipulating how CTs are to be safely performed.

Computed tomography imaging, known as CT, is a diagnostic procedure that uses special x-ray equipment to obtain cross-sectional pictures of the body that provide detailed images of organs, bones, and other tissues. CT is associated with higher radiation exposure than conventional x-rays, yet radiation dosages that patients receive from the newer CT scanners have gone largely unregulated, according to Smith-Bindman, who also is a UCSF professor of epidemiology and biostatistics and obstetrics, gynecology and reproductive sciences.

CBS News' Dr. Jon LaPook will more on this new development on tonight's CBS Evening News, at 6:30 p.m. ET/PT.

[mcapek]

There is that lingering perception that low dose noisy images are subpar for a diagnostic use. And if you are going to spend the big bucks for CT or MRI, you would like to get as much information out of the study as possible. But if the radilogical societies come out and say its okay and standard of care to use limited quality scans, rather than the best possible, for diagnosis, because of risk of future radiation induced cancers, lot of people may go along with it.
What do you think low dose will do for e.g. coronary artery or pulmonary CTAs?

[Dave_Fisher]

Media coverage of the two recent studies published in the Archives of Internal Medicine, claiming increases in cancer due to use of computed tomography (CT), raises vital public policy issues that must be considered.

First, it?s important to understand that medical imaging manufacturers have made incredible strides in innovating advanced equipment that minimizes radiation dose. In fact, new medical imaging technologies and systems introduced during the past 20 years have significantly reduced radiation dose.

Even with this progress, manufactures continuously explore the next frontiers of innovative medical imaging technology that will exponentially reduce radiation exposure while exponentially increasing the capability and quality of the images it delivers -- allowing physicians to save more lives. To that end, we believe policymakers should encourage technologic development so that companies can continue to innovate and produce diagnostic equipment that reduces radiation dose and improves patient outcomes.

Next, while nobody disputes the effectiveness of CT scans, the assertion that CT scans are overused is an outdated perception. In fact, an analysis of Medicare claims data from 1998-2007 demonstrates that beginning in 2007, spending on advanced diagnostic equipment decreased by 19.2 percent while volume grew by a modest 1.9 percent. Any claims that the use of CT is rapidly growing is false.

Imaging manufacturers believe that the way to continue driving proper use of CT, as well as other diagnostic equipment, is to ensure physicians have access to, and are relying on, evidenced-based guidelines at the point of care to determine which diagnostic test should be ordered (or not ordered). That?s why MITA strongly endorses a robust build-out of appropriateness criteria in the Medicare program, and research supports this approach. This is the best way to drive proper utilization while ensuring patients have access to the diagnostic procedures they need.

Lastly, it?s important to point out that medical imaging, when used appropriately, minimizes other risks that more invasive procedures present to patients, and enables doctors and patients to more effectively tackle the very real and very deadly diseases they already have. We must preserve access to these scans while smartly fostering the development of new technologies and ensuring their proper use.

Dave Fisher
Managing Director
Medical Imaging & Technology Alliance (MITA)

[hanleymike]

Visit www.xrayrisk.com for more info.

The site is dedicated to improving the understanding of radiation risks from medical imaging. Calculate dose and estimate cancer risk from studies including CT scans, x-rays, nuclear scans and interventional procedures.

[erasmus111]

"Cancer from CT Screenings?"


Duuuuuh!!!!

Of course you can get cancer from CT screenings. Having mammograms, chest x-rays, lung x-rays, teeth x-rays etc, can give you cancer. They all add up!

Chemotherapy may get rid of the cancer you have now, but down the road it will give you cancer. None of this stuff is good for you, so you got to know it's going to get you in the end.

[mcapek]

Yawn, Dr. probably needed to write another paper, publish or perish. This is old news. All the CT scan manufacturers have been working on dose reduction for some time.

The choice is: having a CT scan, and tiny statistical risk of increased cancer in a large population of patients, or not having the CT scan and having undiagnosed cancers, abscesses, strangulated bowel and other problems that will kill the patient NOW without treatment. Which is more important to the patient?

[lmartink]

The real problem with your argument is that no one uses the "Low Dose" feature that is standard equipment on all CT scanners.

[mcapek]

So what is your theory why "no one uses the Low Dose feature"? There must be a reason, such as worse image quality, right?