December 13, 2007
The increasing use of Computed Tomography (or “CT”) scans in today’s hospitals has prompted health professionals to take a closer look at the potential effects of the radiation from those scans, and to consider how patient radiation exposure during the procedure can be minimized.
Earlier this month, a group called RCG Health Care Consulting, led by Dr. Giles Boland, Vice Chairman of the Department of Radiology at Massachusetts General Hospital (MGH), announced that it had established a series of CT practices and protocols which would allow radiologists to reduce radiation exposure while still being able to obtain diagnostic-quality images from their CT scans.
Dr. Boland and his colleagues in the MGH Department of Radiology have spent ten years devising specific protocols for adult and pediatric scans. These protocols, which include exact parameters for each step of each different CT scan, are expected to enable a physician to decrease the patient’s total level of radiation exposure by up to 60%.
“There are more than 64 billion CT scans being performed in the U.S. each year,” Dr. Boland told me in a telephone interview conducted earlier today. “[A CT scan] is now on the critical pathway of most major diseases. More physicians want CT scans so that they can look at blood vessels and inside structures.”
When these tests are ordered, he said, “it is the responsibility of radiologists to have protocols in place to minimize the level of radiation” exposure to patients, so as to reduce the risk of radiation-induced cancer.
Due to the fact that there is no “tangible” evidence of the adverse effects of medical radiation, said Boland, many organizations still haven’t addressed issue. “The science is still theoretical,” he said. “Most of the data we have on the potential risk of cancer is still derived from Hiroshima data [from the after-effects of the 1945 atomic bomb] and extrapolated from there.” Further, the ability to decrease radiation while maintaining CT quality is “just not readily available at a medium-sized hospital.” To come up with a system for doing so, a radiologist “would have to reinvent the method, protocol by protocol” – something practitioners simply do not have the time to do.
Having themselves completed the process of devising the over 100 radiation-reducing CT protocols, Boland and RCG moved to fill the growing opening in the radiology market by transforming their new, low-radiation technique into a product which will be available to radiologists outside of major medical centers.
“There has been considerable academic interest” in the protocols, said David Charpie, Executive Director of RCG. Whether this new method will be mandated by government or will be voluntarily adopted by hospitals across the country remains to be seen (it will “probably be a combination of both at the end of the day, said Charpie). However, Boland pointed out that, with the work on developing the straightforward protocols already having been done, this new method can be “seamlessly” integrated by radiologists “with minimal disruption of their workflow,” leaving little reason for hospitals not to voluntarily move toward lower-dosage CT scanning.
“It took ten years of development to get where we are today,” said Boland. “Doctors will want to [lower CT radiation] as quickly as they can, rather than do ten more years of work on their own.”
Jeff Emanuel is The Heartland Institute’s health care policy research fellow and managing editor of Health Care News.