Radiation Risks from Medical Imaging Tests | Arthritis Information

 

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NEW YORK TIMES

Study Finds Radiation Risk for Patients

  ALEX BERENSON

At least four million Americans under age 65 are exposed to high doses of radiation each year from medical imaging tests, according to a new study in The New England Journal of Medicine. . . .

. . . .The use of the tests has risen sharply in the last two decades, as more and more physicians have bought CT and PET scanners and installed them in or near their offices. In 2007, the Department of Health and Human Services estimated that the number of CT scans given to Medicare patients had almost quadrupled from 1995 to 2005, while the number of PET scans had risen even faster.

The new study’s lead author, Dr. Reza Fazel, a cardiologist at Emory University, said the use of scans appeared to have increased even from 2005 to 2007, the period covered by the paper.

“These procedures have a cost, not just in terms of dollars, but in terms of radiation risk,” Dr. Fazel said. . . .

Federal rules allow physicians to profit from the use of machines they own or lease. But Dr. Harlan M. Krumholz, a cardiologist at Yale and an author of the paper, said financial incentives were only part of the reason the number of tests had risen so fast.

“I think the central driver is more about culture than anything else,” Dr. Krumholz said. “People use imaging instead of examining the patient; they use imaging instead of talking to the patient.

“Patients should be asking the question: ‘Do I really need this test? Is the information in this test going to help in the decision-making process?’ ”

In many cases, there is little evidence that the routine use of scans helps physicians make better decisions, especially in cases where the treatments that follow are also of questionable efficacy.

In an editorial accompanying the paper, Dr. Michael S. Lauer, director of prevention and epidemiology at the National Heart, Lung and Blood Institute, called for large clinical trials that would assess whether the scans improve care and lead to better outcomes for patients.

“Were we to insist that all, or nearly all, procedures be studied in well-designed trials, we could answer many critical clinical questions,” Dr. Lauer wrote.

Until then, patients and physicians should discuss the risk of the tests and keep close track of the overall radiation dose that patients are receiving, he wrote, adding, “We have to think and talk explicitly about the elements of danger in exposing our patients to radiation.”

TO READ COMPLETE ARTICLE:

http://www.nytimes.com/2009/08/27/health/research/27scan.html

Joie2009-08-29 00:41:27 _popupControl(); My pet peeve---x-rays--- mamograms, chest x-rays, x-rays to check damage from RA, dental x-rays-seems evey time I go to a dr. -- they want something xrayed.  I have refused sometimes and you get treated  negatively.  Money makes the world go round!!!!I agree Catnip2. I also refuse non-essential xrays. It's rediculous how many you get in a year!


Oh and I forgot to add, you are so right. You do get treated negatively. My dentist said he didn't want me as his patient anymore. I had the round the head xray and a bite wing done every 3 years (and I have NO problems with my mouth/teeth) but I guess that wasn't enough for him. I was given the ultimatum to either get xrays every year or leave the practice. I left the practice. I guess I wasn't profitable enough for him.

Also, wanted to add that I try to get my xrays that I do have done, done on digital equipment. Little less radiation from them, at least that's what I understand.cheesehead2009-09-04 21:37:20my issues w/ some testing is that the doc orders an x-ray.. but the x-ray isn't definitive and therefore you need a cat scan... and then for further info, get an MRI with dye... [QUOTE=babs10]not insurance requirements due to expenses of each?  having to succumb to the lesser first?Don't forget the patients who think that every bump, twist or ache needs to be x-rayed and if it isn't, it's because the doctor/insurance company "doesn't care" ...and the ones for whom a negative x-ray just isn't enough reassurance so demand a CT or MRI plus every other test known to current medical science.


ahhh... LOLWith as many x'rays as I have had I should be glowing from all the radiation.  After 7 joint replacements and a 24 year history with RA you can imagine how often they take pictures.  I finally decided not tow worry about the radiation...there isn't much I can do about it now _popupControl(); One time when I declined to have routine x-rays at the dentists--they made a note in my file and made me sign it saying I declined.  Then the hygientist had a bug up her _____ the rest of my appointment!  I've given up on worrying about exposure.  Like Buckeye, I also should be glowing.   Ten years of out of control RA, PsA, and OA the last few years has left me little choice, especially with pulmonary and cardiac RA complications.....so I just don't worry about it.  LindyThe article was about radiation from medical imaging tests -- like CT scans, not x-rays.

I had 3 CT scans in a six month period.  I didn't ask for them.  I had gone into hospital with what was later diagnosed as atypical pneumonia.  Because I've had RA for over 3 decades and been on mtx for over 2 decades, and both of these could affect my lungs, the pulmonologist ordered the first ct scan, and I had a second ct scan 4 months later.

I have been having a vision problem for 2 years, a double/overlapping vision, which finally got diagnosed as fourth nerve palsy.  The opthalmologist ordered a ct scan of my brain. 

After reading this article, I wonder if I should have delayed the 3rd ct scan.

From now on I will ask more questions and keep track of the radiation dose.    
[QUOTE=Joie]The article was about radiation from medical imaging tests -- like CT scans, not x-rays.

I had 3 CT scans in a six month period.  I didn't ask for them.  I had gone into hospital with what was later diagnosed as atypical pneumonia.  Because I've had RA for over 3 decades and been on mtx for over 2 decades, and both of these could affect my lungs, the pulmonologist ordered the first ct scan, and I had a second ct scan 4 months later.

I have been having a vision problem for 2 years, a double/overlapping vision, which finally got diagnosed as fourth nerve palsy.  The opthalmologist ordered a ct scan of my brain. 

After reading this article, I wonder if I should have delayed the 3rd ct scan.

From now on I will ask more questions and keep track of the radiation dose.    
[/QUOTE]

A CT scan is just a series of x-rays.
[QUOTE=JasmineRain] [QUOTE=Joie]The article was about radiation from medical imaging tests -- like CT scans, not x-rays.

I had 3 CT scans in a six month period.  I didn't ask for them.  I had gone into hospital with what was later diagnosed as atypical pneumonia.  Because I've had RA for over 3 decades and been on mtx for over 2 decades, and both of these could affect my lungs, the pulmonologist ordered the first ct scan, and I had a second ct scan 4 months later.

I have been having a vision problem for 2 years, a double/overlapping vision, which finally got diagnosed as fourth nerve palsy.  The opthalmologist ordered a ct scan of my brain. 

After reading this article, I wonder if I should have delayed the 3rd ct scan.

From now on I will ask more questions and keep track of the radiation dose.    
[/QUOTE]

A CT scan is just a series of x-rays.
[/QUOTE]

Oh.  Guess I shouldn't be concerned then.  Thanks.
[QUOTE=LinB]...the last few years has left me little choice, especially with pulmonary and cardiac RA complications.....so I just don't worry about it.  Lindy[/QUOTE]
That has become my policy as well: keeping track of RA and its concomitant chronic illnesses is, at this point, more important than the radiation risks.

We each do what we have to do to manage our physical conditions.

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