Exposure to medical radiation is a hot topic in the media. The issue becomes more even rise to the disaster of nuclear plants affected by the tsunami in Japan. It’s a question that has permeated European consciousness for decades and the American College of Radiology ( ACR ) has recently been propelling. It is our duty and responsibility to educate ourselves as physicians turn to address the concerns of our patients.
With the advent of technological advances, such as computed tomography (CT) and nuclear medicine equipment hybrid PET-CT and SPECT-CT, an increase has occurred in the exhibition. Thus, annual cumulative dose of radiation for diagnostic medical studies between 1980 and 2006 has increased by 700%. While in 1996, the total dose of radiation medical studies, that accumulated in CT studies was 5% of the total, CT 2006 represented 34%. The increased use of CT has been exponential: nos 3 million studies in 1980. 20 million in 1995 to 67 million in 2006. These figures continue to rise with the same trend. In the United States, about 150,000 CT scans performed daily, representing about 25% of CT scans worldwide. If we assume an average annual growth using 10-15% l, within the next five years, essentially all EU citizens will have been done a CT scan. We must emphasize that over 4 million patients younger than 15 years these tests are performed, it is precisely the most radiosensitizing and increased life expectancy so people are more likely to be exposed repeatedly during his lifetime.
Medical radiation exposure is one that can reduce. However, this statement must be tempered in the context of our planetary reality, so as to prevent mass hysteria and in the process millions of patients fail to benefit from diagnostic tests. For example, Radon is a colorless, odorless and tasteless gas that occurs as part of the decay of uranium, with a long half life (4.5 billion years). For all purposes, this gas will be present throughout our lives and many previous and future generations to ours. Radon is responsible for most public exposure to ionizing radiation and often represents the largest contributor of radiation that everyone receives in his life. This gas from natural sources tends to accumulate in buildings, especially in confined as are basements areas. We all know that breathing high concentrations of radon can cause lung cancer and is responsible for the second cause of this tumor according to the EPA. No one can avoid exposure to radon and not much we can do. The same goes with that radiation to which we all submit every time we travel by plane or who are exposed those living in highly elevated areas being closer to the radiation emitted by the sun.
All healthcare that uses radiation for diagnostic and therapeutic purposes should be governed by the ALARA principle, stands for As Low As Reasonably Achievable . The initiative organized most current impact is educational campaign created by the Alliance for Radiation Safety in Pediatric Imaging formulated in 2001. It is based on over 35 health organizations with over half a million professionals radiology, pediatrics, physical Medical and Radiological Health. This campaign is known as Image Gently (cybernetics page: www.imagegently.org ) and, although originally intended for pediatric studies, it has been expanded to include patients of all ages: Image Wisely .
The process of awareness of the issue includes promoting educational principles within each institution, referrers medical guide as to what sort of first instance mode according to the clinical condition, integration of the ACR Appropriateness Criteria ( www.acr.org also available as an app for the IPhone) as part of the order system studies in hospitals, among others. The creation of centralized data repositories, presently developing in PR, help avoid unnecessary duplication of studies. Should consider alternatives such as sonography and MRI and identify facilities that provide cardiac MRI (without ionizing radiation) and coronary angiography (CCTA) made equipment capable of applying the lower radiation equipment such as dual X-ray tube (Siemens Definition ), among others. In most studies tracking PET-CT scan requiring much if not the whole body dose may be reduced routinely CT.
In addition to familiarize yourself with knowledge in the field radiologist and radiologic technologists optimize the reduction of X-ray dose applied and also to use those teams with the capabilities to generate diagnostic images using the lowest possible radiation, referrers doctors should be able to educate patients who require studies that use ionizing radiation regarding the risks plus benefits. This scenario is common in both emergency rooms and individual offices and clinics.
It is important to note that the German company Siemens Healthcare was honored in 2010 with the award North American Frost & Sullivan Award for Technology Leadership of the Year in recognition of its commitment to development and research in the area of reducing radiation dose of CT scans . Each year, Frost & Sullivan presents this award to the company that has demonstrated unique achievements related to the development of technology that significantly impact the functionality of your new equipment, in this case the benefit of lower radiation exposure to patients. The race to scan faster and more accurately among the major manufacturers has just been qualified by the very important need to take into account the radiation dose. This will motivate all equipment companies invest their best human capital to reduce the radiation dose to a minimum without sacrificing diagnostic image quality.
Investing in machines that although more expensive, emitting the least possible radiation, and learn to maximize them, represents an investment to social and economic welfare. This is an issue that must be incorporated as one of the cornerstones of our practice, which will result in practice better medicine, more cost-effective and healthy for all system components.
Author: Dr. Fernando Zalduondo Dubner, email@example.com