Radiation Safety Management: Always an Important Goal

In 2010, Newsletter, Volume 2 Issue 3 by Addison Clark

Medical radiation exposure has been a recent topic in the lay press. While certain imaging modalities such as ultrasound and magnetic resonance imaging (MRI) do not expose patients to ionizing radiation, others, such as computed tomography (CT), plain film radiographs, and fluoroscopy, do.

All of these studies have revolutionized the practice of medicine and saved countless lives. Nevertheless, too much medical radiation may possibly lead to the development of malignancy 15-20 years in the future.

How many X-rays or CT scans can a patient have before he or she is at increased risk? “No one knows for certain,” said Christopher M. Meyer, MD, board-certified diagnostic radiologist with Radiologic Associates of Fredericksburg (RAF). “There is no known lifetime dose threshold establishing a definite link between medical radiation and cancer. In every procedure, however, it is our responsibility to ensure that our patients’ lifetime exposure to medical radiation is kept as low as reasonably possible while still detecting disease as early as possible.”

RAF strives to provide the highest-quality images while keeping exposure to medical radiation as low as possible. The practice has several precautions in place to manage patient safety:

CT scanners are equipped with dose modulation. The amount of radiation administered is automatically adjusted based on the size of the patient or body part. Larger patients and larger body parts require more radiation to penetrate the body and generate high-quality diagnostic images, while smaller patients or smaller body parts require less. Dedicated pediatric protocols are also in place to “child-size” radiation doses used in children’s imaging, in keeping with the Image Gently™ initiative by the Alliance for Radiation Safety in Pediatric Imaging. RAF is in frequent contact with the alliance to ensure its radiologists and technologists receive the latest education and are utilizing state of the art technology to image children as safely as possible.

Special precautions are taken to protect radiosensitive organs. For example, breast shields and thyroid shields are used during CT scans to decrease the radiation absorbed by these areas. Also, the amount of radiation used in generating images for virtual colonoscopies is intentionally lowered for patient safety without compromising image quality.

CT studies are monitored to ensure that the CT dose index is within the accepted guidelines of the American College of Radiology. These checks are conducted randomly and retrospectively each quarter. “We have been very pleased with our performance to date,” Dr. Meyer said.

Protection is optimized in fluoroscopic imaging. Fluoroscopy times are recorded for retrospective analysis, and screen-save technology is used. The last image saved on the overhead monitor is directly uploaded onto the PACS [Picture Archive Communication System]. This negates the need for a second spot image, thus reducing the radiation dose. Pulse fluoroscopy technology is also used, delivering an intermittent rather than continuous beam to help decrease the radiation a patient receives. This is especially important when imaging children.

Radiation safety management, Dr. Meyer noted, is “a work in progress,” requiring ongoing monitoring and modification of protocols with the advent of new technologies. “In choosing the best imaging modality for each patient, the input of our referring clinicians is key.

We are always available 24 hours a day to review or discuss cases, so please feel free to contact us

For more information, contact Christopher M. Meyer, MD, at meyer@rafimaging.com or call (540) 361-1000 and leave a message.