OGDEN -- Computed tomography (CT or CAT) scans help doctors diagnose everything from brain tumors to heart disease. But how much does radiation from these and other imaging tests put you at risk for developing cancer later in life?
Now you can find out. Intermountain Healthcare's hospitals and clinics have been compiling cumulative radiation exposure samples from high dose tests for patients and their physicians that reveal just how much they've been impacted over the last year.
The tests, tracked since August 2012, include CT and nuclear medicine scans and interventional radiology exams. Soon the company will begin tracking mammograms, X-rays and other similar screenings.
The hospital chain, which is the first health care system in the country to release cumulative exposure reports to patients, wants to do all it can to reduce exposure to radiation while providing quality health care, said Dr. Don Lappe, medical director over Intermountain Healthcare's cardiovascular clinical program. Knowing a patient's cumulative radiation exposure can help physicians and medical caregivers determine which type of imaging test is best.
Most medical imaging tests add only a small fraction of radiation exposure when compared to natural sources of radiation, he said, and there is no consensus among experts about the magnitude of cancer risk. A chest X-ray uses about the same radiation as living in your natural surroundings for about 10 days. With that said, doctors agree patients shouldn't be exposed to any more radiation than necessary.
"There are national statistics as to the average amount of radiation tests use, but it varies from patient to patient, depending on the type of image that is needed," he said. "CTs use far more radiation than a mammography or ankle X-rays. Generally, a head CT would use less radiation than an abdominal CT."
Women have twice the risk as men for radiation exposure because of breast cancer concerns, he said. However, he said, Intermountain routinely reviews its processes and works hard to use the least amount of radiation necessary to produce high quality diagnostic images.
According to an article published in the New England Journal of Medicine, as many as one-third of all CT scans performed in the country were deemed unnecessary. Included in that figure are roughly 20 million adults and one million children per year. Part of the problem, according to the authors, stems from doctors practicing defensive medicine, worried they may be accused of not doing enough.
According to the Food and Drug Administration, cancer from a CT scan would take roughly 20 years to develop.
The risk for children is even higher. A study published in the American Journal of Radiation states children have longer life expectancies and their cells divide more rapidly which causes their DNA to be more vulnerable to damage. Newer machines can be adjusted to deliver up to 50 percent less radiation on children and Lappe said due to improvements in technology, the tests are shorter. He added that much of the clinical movement to decrease radiation exposure has emerged from the pediatric radiology community and radiologists at Primary Children's Medical Center, which is owned by Intermountain Healthcare.
For example, Primary Children's is one of six pediatric hospitals nationally participating in a study to establish benchmarks for appropriate radiation exposure in pediatric CT exams.
While some tests can be done using ultrasound or magnetic resonance imaging (MRI) there are times when radiation imaging is needed, such as internal bleeding, severe head trauma and acute abdominal pain.
"We are very excited to begin to see the benefits of monitoring cumulative radiation. With this information, clinicians and staff have reduced radiation, avoided unnecessary treatments and found alternatives which do not involve X-rays," Lappe said.
However, when CT scan or another imaging test is deemed necessary, patients should get it, Lappe said.
"The radiation doses are not significant enough compared to the benefit of extending lives, saving lives and improving the quality of lives. Sharing the cumulative radiation number with patients and their healthcare providers is just one of the many steps Intermountain takes to increase safety from medical radiation," he said.
Patients of Intermountain Healthcare can go to IntermountainHealthcare.org and click on the "My Health" link to view their radiation exposure. The free service is password protected.