Medical radiation exposure has been a recent, and frequent, topic in the lay press. While certain imaging modalities such as ultrasound and MRI do not expose patients to ionizing radiation, others, such as CT, plain film radiographs, and fluoroscopy, do. All of these studies have revolutionized the way we practice medicine and have saved countless lives. Nevertheless, too much medical radiation may possibly lead to the development of future malignancy 15–20 years down the road. Unfortunately, a lifetime dose threshold establishing a definite link is not yet known. What this means is that no one knows exactly how many xrays or CT scans a patient can have before he or she is at increased risk. Therefore, it is incumbent on the radiologic community to ensure that the patient’s lifetime exposure to medical radiation is kept as low as reasonably possible while still detecting disease as early as possible.
We want to assure the medical community that Radiologic Associates of Fredericksburg has always strived to provide the highest-quality images while keeping patient radiation exposure as low as possible. Patient safety, both short and long term, has always been our priority. I would like to describe a few of the precautions we take “behind the scenes” to ensure that radiation exposure is kept to a minimum.
Our CT scanners are equipped with dose modulation, which automatically adjusts the amount of radiation administered based on the size of the patient or body part. Larger patients/larger body parts require more radiation to penetrate the body and generate high- quality diagnostic images. Less radiation is required for smaller patients or smaller body parts. This individual dose customization ensures that no patient receives too much radiation to produce such images, a safety measure especially important in the pediatric population. Dedicated pediatric protocols are also in place to ensure that we image children “gently,” in keeping with a recent American College of Radiology initiative. Female breast tissue is a radiosensitive organ. Therefore, we place breast shields on female patients during CT scans to decrease the radiation absorbed by the breast. We also use thyroid shields in the same way. The amount of radiation used to generate images for our virtual colonoscopy program are intentionally lowered for patient safety without compromising image quality.
We randomly and retrospectively monitor CT studies on a quarterly basis to ensure that the CT dose index (the amount of radiation administered during a study) remains within the accepted guideline of the American College of Radiology. We have been very pleased with our performance to date.
Fluoroscopy is an operator-dependent modality, and all of our radiologists are cognizant of the amount of fluoroscopy time used during each study. The fluoroscopy times are also recorded for retrospective analysis. We use “screen save” technology, which stores the last image saved on the overhead monitor directly onto the PACs system. This negates the need for a second spot image, thus reducing the radiation dose. Pulse fluoroscopy is also used. This technology delivers an intermittent beam rather than a continuous beam to help decrease radiation delivered to the patient, a measure that again is especially useful in pediatric fluoroscopy.
We enjoy working with our referring clinicians to choose the correct imaging modality for their patients. If there is another study that does not use ionizing radiation while providing equal or better diagnostic information, we actively encourage the alternative exam. All of our radiologists are happy to talk with our referring clinicians about what would be the best test for their patients. We are always available 24 hours a day to review or discuss cases, so please feel free to contact us at anytime.
In the end, we are all responsible for the amount of medical radiation our patients receive. We at Radiologic Associates of Fredericksburg will continue to use the newest technology and imaging techniques to ensure that the patients in our community are imaged as safely as possible.