Amid growing concern about the cancer risk of improperly administered medical radiation, last month the Food and Drug Administration proposed new guidelines designed to prevent accidental radiation overdoses from the machines used for CT scans, nuclear medicine and fluoroscopy. But at a recent House subcommittee hearing, testimony made it clear the problem is bigger than can be solved by better technology – and that the focus on radiation safety must also include the risks of radiation from routine X-rays.
The New York Times – which in January ran a blockbuster series on radiation overdoses, reported:
Much of the hearing focused on CT scans, which are largely responsible for a sevenfold increase since 1980 in the average lifetime dose of diagnostic radiation. As evidence of their power, an abdominal CT scan “delivers approximately the same radiation as getting 1,500 dental X-rays,” said one witness, Rebecca Smith-Bindman, a professor of radiology, epidemiology and biostatics at the University of California, San Francisco.
Given the dangers of too much radiation, Dr. Smith-Bindman said, it is important that the lowest possible dose be given.
Higher-than-needed doses of radiation are all too common in medical imaging and are often due to inadequate training of personnel and inadequate regulation. Experts estimate that in many procedures the radiation dose could be cut as much as 50 percent without sacrificing image quality. The radiation dose for a mammogram has been reduced from 2 rads in the 1970s to 0.2 rads today, for example. The current law regulating radiology dates from 1981 and made the adoption of professional standards for radiology voluntary.
The Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy (CARE) Act currently in front of Congress would require states to meet minimum standards for quality assurance through licensing and training of radiology professionals. This act, sponsored by the American Society of Radiologic Technologists, would also ensure that patients undergoing all types of radiological procedures would have the same assurance of quality as patients who get mammograms currently do under the provisions of the Mammography Quality Standards Act. Requiring minimum training standards would reduce the need for repeated tests and improve the safety of radiologic procedures, thus reducing the risks of medical radiation.