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Medical imaging has transformed the practice of medicine as imaging studies increasingly replace more invasive, and often more costly, techniques for any number of indications. However, the amount of radiation the U.S. population receives from medical imaging has risen 750 percent in the last 25 years, according to the preliminary results of a report of the medical subgroup of the National Council on Radiation Protection and Measurement (NCRP).

Medical imaging may now be the largest source of radiation exposure in the United States, topping natural sources, said Fred A. Mettler Jr. M.D., of the New Mexico Federal Regional Medical Center. The collective annual dose of radiation from radiology and nuclear medicine is 930,000 person-Sv, he estimated, while the dose from natural background sources may be less than 900,000 person-Sv.



"I don't think most radiologists have a clue about how much this has grown," Mettler said in an interview after the presentation. He presented the results Monday, at this year's National Council on Radiation Protection & Measurements conference in Arlington, Va. The full report is likely to be published in 2008.

Also, the American College of Radiology (ACR) just released the ACR White Paper on Radiation Dose in Medicine, a far-reaching and extensive set of recommendations designed to counteract medical and societal trends that have contributed to any increased radiation dosage that Americans may experience as this beneficial technology advances.

The paper advocates 33 separate measures, including a plan to educate patients, doctors, and others in the principles of radiation safety and appropriate use of imaging, as well as a dose index registry, which is now in progress. The ACR has long been involved in other efforts to make medical imaging safe, such as publishing guidelines and technical standards and offering accreditation programs and a patient education Web site, www.radiologyinfo.org, a cooperative effort with the Radiological Society of North America. (www.rsna.org)

The size of the increase in the collective annual dose was a surprise to many who attended the conference. The increase stems from the growth in the number of scans being done, and from larger doses delivered by new kinds of scans. CT scans deliver the largest portion of the annual collective dose, 440,000 person-Sv, with chest and abdominal and pelvic scans delivering the largest shares, 17 percent and 58 percent, respectively, of that number. Nuclear medicine procedures account for 220,000 person-Sv of the collective dose, with cardiac studies accounting for more than 85 percent of that total.

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