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The Image Gently Alliance 10 years later: challenges met and the future direction

By Dr. Marta Hernanz-Schulman
From the March 2018 issue of DOTmed HealthCare Business News magazine

The Image Gently Alliance, conceived to educate about the informed use of radiation as well as decrease and manage radiation exposure in pediatric patients, was launched in January 2008, originally named The Alliance for Radiation Safety in Pediatric Imaging.

The Alliance was initially envisioned by the Society for Pediatric Radiology (SPR) through the inspiration and leadership of its then- President Marilyn Goske, and was founded by four pillar societies, the SPR, the American Association of Physicists in Medicine (AAPM), the American College of Radiology (ACR) and the American Society of Radiologic Technologists (ASRT). Since that time, the influence of this campaign has reached the global stage with links to the International Atomic Energy Agency (IAEA), the World Health Organization (WHO) and connections with multiple regulatory agencies including the Food and Drug Administration and The Joint Commission. The 101 allied organizations represent more than 1 million members.

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The beginning
The impetus for the creation of this new Alliance was increasing awareness of potential stochastic (cancer-causing) effects of radiation exposure that was brought to medical, and later lay, attention at the beginning of the 21st century. This included articles by Brenner and Hall in 2001, echoed by the BEIR VII publication in 2006, and data from the National Council on Radiation Protection and Measurements indicating that between 1987 and 2006 man-made radiation had increased from 18 percent to 48 percent of the total population burden while CT alone accounted for nearly half of that fraction.

To add to the growing scrutiny of medical radiation, CT settings were not being adjusted for children. The founding working group of pediatric radiologists, ACR , ASRT and AAPM representatives, working on what they conceived as a National Radiation Safety Initiative during the planning meetings through 2007, outlined a goal of educating target populations with the intent of changing practice via social marketing. The target populations were defined as radiologists, technologists, referring health care providers and parents and caregivers.

The task of educating these large segments of the population on radiation issues relative to all imaging modalities was correctly perceived as monumental, and was therefore subdivided into discrete campaigns, prioritizing areas of greatest impact. The message was to be simple, resonant, powerful and memorable. The stated mission of this Alliance was to change practice at the local, national and international levels, by using the right amount of radiation, or child-sizing the dose when imaging children. This was to be accomplished through education and with the cooperation of the allied societies.
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