A New York Times op-ed about nuclear radiation exposure, called “Unsafe at Any Dose,” got me thinking about CT scan radiation exposure – and the ongoing debate regarding CT scan risks.
Many activities and endeavors in human life have associated risk. Driving a car is risky; people die. And the more miles you drive, the greater the risk. But that does not mean we don’t use cars. Rather, we minimize risk by driving carefully, using seatbelts, etc. And we go ahead and drive in order to capture the benefits.
So it is with medical radiation… and nuclear energy. But an important note: even with Dr. Caldicott’s pessimistic predictions and numbers, if you look at human deaths associated with kilowatt hours of electrical generation, coal powered electricity is the worst. Oil is next, and nuclear is at the vary bottom of the list (i.e., it has historically caused the fewest deaths).
Makes one stop and think, doesn’t it?
A correct or partially correct assertion. But…
Appropriateness is now coming under focus by providers and payers as never before. And formal Decision Support programs as part of computerized order entry are appearing – which brings a large body of knowledge to bear on appropriateness at the point of order entry.
CT scanners have many safety features – but not all the ones we might use in imaging. However, very soon features which very visibly flag protocols whiich use more radiation than necessary and ask to reconfirm will be running on all new and most recent model scanners.
Tech training and certification is advance, but becoming more focused on dose. At our two CT Low Dose Symposia, about half of the 300 participants were technologists. In general, they are very motivated about both does and education.
So it is very likely that the near future will be substantially more dose-efficient.
The problem is recieving a cat scan when it was not necessary, machines with no safeguards, and ill trained technologists. Everybody know that cat scans are sometimes necessary. The public is not stupid.