URMC Continues in its Commitment to 'Image Gently'

January 04, 2010

CT scans inform treatment decisions for many diseases.

With recent research making headlines and raising questions about the safety of CT (computed tomography) scans, the University of Rochester Medical Center is proud to reassure both its referring physicians and the Rochester community of its continuing commitment to “image gently” by reducing radiation dose whenever possible. 

“You can’t discount the value of these medical exams,” said David Waldman, M.D., Ph.D., professor and chairman of Imaging Sciences at URMC. “Over the years, they’ve been helping us catch cancers sooner and improve life expectancy. Still, some of them, like CT scans, confer a limited degree of radiation exposure to the parts of the body being scanned, and as physicians, it’s our duty to employ these technologies responsibly.”

CT scanners – large, donut-shaped machines that rotate around a patient to capture 2-D pictures (or “slices”) of bone and soft tissues inside the body – work by emitting X-rays. And because radiation has been linked to cellular mutations and the resulting cancers, both clinicians and professional organizations, such as the American College of Radiology (ACR), are increasingly careful to make sure these diagnostic exams are safe and effective.

One way to ensure that radiologists keep abreast the latest “best-practices” is to seek accreditation by the ACR – a key stamp of approval signifying that a facility’s machines are functioning optimally and both its technologists who perform scans and its physicians who interpret them have met training and certification requirements. URMC and its affiliates are not only ACR-accredited, but already adhere to two fundamental safety principles: first, that no imaging exam should be performed unless there is a clear medical benefit that outweighs any associated risks, and second, that radiation dosing for every scan is “as low as reasonably achievable” while still providing a useful picture (commonly referred to as the ALARA principle).

“In December, we actually installed new ‘dose-reduction’ software on both of the existing CT scanners at University Medical Imaging, our associate over at the Clinton Crossings complex,” Waldman said. “These are the first two units in upstate New York to be outfitted with this special technology, which allows technologists to render equivalent images with nearly 40 percent less radiation.”

Throughout 2010, Strong Memorial and Highland hospitals also will make a significant investment by implementing a beta-test version of Philips’ dose-reduction software on many of their CT machines. Waldman said this technology expenditure is a natural extension of URMC’s ongoing patient safety efforts to regulate and reduce radiation exposure whenever possible.

“This certainly is not the first study to propose a link between CT scans and supplementary cancers – but with so much press, it’s certainly entered the national consciousness this winter. Understandably, patients will have questions and concerns about our decisions to scan,” Waldman said. “We’re looking forward to answering them.”

The literature has yet to prove a direct link between imaging radiation and cancer. In fact, the Archives of Internal Medicine articles that caused the public stir in December were modeled based on the rates of cancer occurring in people exposed to radiation from the atomic bombs dropped on Japanese cities at the end of the second World War – a comparison many experts contend is unfair. Even if the supplemental cancers estimate projected by these World War models is close to accurate, it represents a very small risk when stacked against the immediate and proven life-saving benefits of CT scans.

Still, dedicated to being prudent even with the “jury still out,” URMC imaging scientists remain devoted to reducing unnecessary radiation exposure.

“We’re especially careful to give ‘kid-sized’ doses to young children, and we follow weight-based protocols,” Waldman said. “They’re still growing so quickly, and their tissue regenerates so much faster. If any group were most at risk for these hypothetical radiation risks, it would be them.”

Learn more about Imaging Sciences at URMC at www.urmc.rochester.edu/radiology.

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Becky Jones
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