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Radiation exposure from
medical imaging on
the rise

Self-Referral Leads to Increased Radiation Exposure, ACR Confirms

Reston, Va. - A recent National Council on Radiation Protection and Measurement (NCRP) report stated that the U.S. population is now exposed to seven times more radiation each year from medical imaging exams than in 1980. The American College of Radiology (ACR), Society for Pediatric Radiology (SPR), Society of Breast Imaging (SBI), and the Society of Computed Body Tomography and Magnetic Resonance (SCBT-MR) urge Americans, including elected officials and medical providers, to understand why this increase occurred, consider the report's information in its proper context, and support appropriate actions to help lower the radiation dose experienced each year from these exams.

"It is essential that this report not be interpreted solely as an increase in risk to the U.S. population without also carefully considering the tremendous and undeniable benefits of medical imaging. Patients must make these risk/benefit decisions regarding their imaging care based on all the facts available and in consultation with their doctors," said James H. Thrall, M.D., FACR, chair of the ACR Board of Chancellors.

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"Medical imaging has revolutionized medicine and is undoubtedly saving and extending lives everyday. It is vitally important that patients do not put off needed imaging care based on this report which neither quantifies the associated health risks nor specifies the radiation protection actions that should be taken," said Society of Computed Body Tomography and Magnetic Resonance President Sanjay Saini, M.D., MBA.

Why This Increase in Radiation Exposure Occurred:

Although the major reason for increased imaging utilization and the associated rise in radiation exposure is the improved health care resulting from these non-invasive, accurate imaging tools, there are concerns about overutilization of these exams.

At a recent international conference David A. Schauer, executive director of the NCRP, cited self-referral, the process by which nonradiologist providers buy imaging equipment and refer patients to these in-office scanners as a primary, preventable driver of this dramatic increase in radiation exposure. Nonradiologist providers often lack even basic radiation safety training and may not be aware of potential repercussions to patients of ordering and often administering high volumes of scans.

Government Accountability Office (GAO) reports as well as peer-reviewed studies published in the Journal of the American Medical Association and elsewhere have shown that when physicians refer patients to facilities in which they have a financial interest, imaging utilization is significantly increased. From 1998-2005, in the Medicare system, the number of self-referred, in-office CT, MRI, and nuclear medicine scans performed grew at triple the rate of the same exams performed in all settings. Private insurance studies indicate that as much as half of this self-referred imaging is unnecessary; in many instances needlessly exposing patients to radiation. Provider fear of litigation, advancing technology, and patient demand may have also contributed to this increase in exposure.
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