New Tracking of a Patient’s Radiation Exposure , WSJ, By LAURA LANDRO, 21 May 13, During a four-week hospital stay, 29-year-old Josh Page had so many CT scans that he lost track, kidding with his doctor about how much radiation he was exposed to—though he admits he had “no clue.” Now, Intermountain Healthcare, where he was treated for an inflammation of the pancreas and underwent surgery in February, is keeping track for him.
The Salt Lake City-based nonprofit group of 22 hospitals and 185 clinics is launching the first major system of its kind to measure and report patients’ cumulative medical radiation exposure from tests that deliver the highest amount of radiation. This includes CT scans, nuclear medicine scans and interventional radiology exams for the heart. In addition to educating doctors and patients about the risks and benefits of medical radiation, Intermountain will allow them to access their exposure data via its electronic health record.
While the benefits of tests and procedures usually outweigh the slightly increased cancer risk from exposure due to radiation, “the risks should be considered before these imaging tests are performed,” says Keith White, medical director of Intermountain’s Imaging Services. This is particularly true for younger patients, who have a higher risk because they live long enough to see long-term effects…… Federal data shows that in 2006, Americans received seven times more radiation exposure than in the 1980s, with much of the increase coming from CT scans and tests that use small amounts of radioactive material to diagnose and assess coronary artery disease. Since 2006, growth in use of CT scans has slowed amid a push for doctors to order fewer tests, both to reduce costs and protect patients from unnecessary radiation exposure. Concern over the potential cancer risks has already led to widespread changes.
Radiology groups, researchers and equipment suppliers are working to lower radiation exposure through improved software programs, and new machines that deliver reduced doses. The National Institutes of Health is incorporating radiation-dose exposure reports into electronic medical records at its own clinical center.
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Nashville, Tenn.-based Hospital Corporation of America, HCA -1.41% the largest for profit hospital system, is planning to track patient doses as part of a new Radiation Right campaign. The American College of Radiology is sponsoring a national Dose Index Registry to allow providers to compare their CT doses against national benchmarks, and is a lead sponsor of Image Wisely, a safety campaign.
Radiation doses are measured in units known as millisieverts, or mSv. Atomic bomb survivor data shows a significant association between developing cancer and a radiation exposure about 100 mSv. But it isn’t clear whether the risk is the same from cumulative exposure in smaller doses, such as multiple CT scans each delivering 10 mSvs. The overall risk of getting cancer in anyone’s lifetime is 40% and some experts feel that 100 mSv of medical radiation can increase this by 1%.
For most medical tests, the added cancer risk is so small it can only be measured on a population rather than an individual basis. And even exposure data isn’t a reliable measure because it can vary highly by such factors as age, gender, the body part exposed to radiation and the patient’s size, says James A. Brink, chief radiologist at Massachusetts General Hospital and co-chairman of Image Wisely…… http://online.wsj.com/article/SB10001424127887324767004578489413973896412.html.