Document Detail


Slowing the increase in the population dose resulting from CT scans.
MedLine Citation:
PMID:  20731591     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The annual number of CT scans in the U.S. is now over 70 million. The concern is that organ doses from CT are typically far larger than those from conventional X-ray examinations, and there is epidemiological evidence of a small but significant increased cancer risk at typical CT doses. Because CT is a superb diagnostic tool and because individual CT risks are small, when a CT scan is clinically indicated, the CT benefit/risk balance is by far in the patient's favor. Nevertheless, CT should operate under the ALARA (As Low As Reasonably Achievable) principle, and opportunities exist to reduce the significant population dose associated with CT without compromising patient care. The first opportunity is to reduce the dose per scan, and improved technology has much potential here. The second opportunity is selective replacement of CT with other modalities, such as for many head and spinal examinations (with MRI), and for diagnosing appendicitis (selective use of ultrasound + CT). Finally, a fraction of CT scans could be avoided entirely, as indicated by CT decision rules: Clinical decision rules for CT use represent a powerful approach for slowing down the increase in CT use, because they have the potential to overcome some of the major factors that result in some CT scans being undertaken when they are potentially not clinically helpful. In the U.S. and potentially elsewhere, legislative approaches are a possible option, to improve quality control and reduce clinically unneeded CT use, and it is also possible that upcoming changes in heath care economics will tend to slow the increase in such CT use.
Authors:
D J Brenner
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2010-08-23
Journal Detail:
Title:  Radiation research     Volume:  174     ISSN:  1938-5404     ISO Abbreviation:  Radiat. Res.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-06     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401245     Medline TA:  Radiat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  809-15     Citation Subset:  IM; S    
Affiliation:
Center for Radiological Research, Columbia University Medical Center, New York, New York 10032, USA. djb3@columbia.edu
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MeSH Terms
Descriptor/Qualifier:
Humans
Neoplasms, Radiation-Induced / epidemiology,  etiology
Radiation Dosage
Risk
Tomography, X-Ray Computed / adverse effects*,  statistics & numerical data
Grant Support
ID/Acronym/Agency:
R01 CA088974/CA/NCI NIH HHS; U19 AI67773/AI/NIAID NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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