by John R. Fischer
, Senior Reporter | November 21, 2019
Radiation dose in diagnostic and interventional imaging has dropped by 15 to 20 percent at healthcare facilities throughout the U.S. over the last decade.
The milestone finding was made by the National Council on Radiation Protection and Measurements (NCRP) in its new report, Medical Radiation Exposure of Patients in the United States
, which examined dose levels between 2006 and 2016. It is a far cry from the organization’s 2009 report, which found a sixfold increase
from the early 1980s to 2006.
"One can deduce that the decrease in overall dose to the U.S. population from medical imaging will have a positive effect in lowering the risk of developing cancers," Dr. Mahadevappa Mahesh, co-chair of the NCRP Report and professor of radiology and radiological science at the Johns Hopkins University School of Medicine, told HCB News. "Even though the cancer risk estimation for medical imaging doses are statistical in nature, it is good to be on the positive end of the spectrum showing the statistical risk is lower compared to the past 10 years."
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Average radiation dose per person decreased among a number of modalities. Overall dose per person for CT, however, remained essentially unchanged, though dose per procedure has declined. The authors chalk this up to a 20 percent increase in the number of exams for this modality, which made up 63 percent of collective dose from medical imaging procedures in 2016 compared to 50 percent in 2006.
The 2019 update credits the decline to improvements in hardware and protocols that enable higher quality images at lower doses. It also attributes the change to shifts from standard film and increased use of digital receptors, as well as efforts by organizations such as the American College of Radiology, the FDA and the Image Gently/Image Wisely programs to increase awareness of the consequences of excessive radiation and the benefits of dose optimization.
"We are pleased, but not surprised, that despite a steadily increasing and aging population, the medical radiation dose Americans receive is going down,” said ACR chief executive officer William Thorwarth Jr. “The radiology community continues to evaluate additional opportunities to further reduce both collective and individual doses while advancing the contribution of imaging to high-quality care. We expect this trend to continue as technology advances and imaging optimization matures.”
He adds that the findings will help pave the way for approval of the appropriate use criteria (AUC), a pending federal mandate that providers would need to consult as a resource before ordering advanced diagnostic imaging exams for Medicare patients. He expects the AUC to extend the declining dose trend by improving imaging appropriateness. “We need to continue to build on this success by moving forward with the Medicare AUC mandate. It is the logical next step.”
The authors will discuss the report in further detail in December at the Radiological Society of North America (RSNA) annual meeting in Chicago.