Diagnostic radiation threats: The debate continues

Some experts say fears of radiation exposure in the healthcare setting are overblown--even sensationalized, according to an article on Medicalxpress.com, which lays out both sides of the long-running debate over medical radiation safety.

Diagnostic imaging procedures should be conducted at the lowest radiation dose to make a diagnosis, the American Association of Physicists in Medicine (AAPM) said in a statement late last month. But clinicians should discuss both radiation risks and benefits of procedures with patients, according to the statement.

"Risks of medical imaging at effective doses below 50 [milliSieverts (mSv)] for single procedures or 100 mSv for multiple procedures over short time periods are too low to be detectable and may be nonexistent. Predictions of hypothetical cancer incidence and deaths in patient populations exposed to such low doses are highly speculative and should be discouraged," AAPM wrote. "These predictions are harmful because they lead to sensationalistic articles in the public media that cause some patients and parents to refuse medical imaging procedures, placing them at substantial risk by not receiving the clinical benefits of the prescribed procedures."

But some scientists criticized the statement, saying that almost any radiation can produce harmful effects, particularly cancer, according to the article. "Scientists disagree as to whether there is a threshold below which there is no risk," article author Joel Shurkin wrote. "Most experts, including the [National Academy of Sciences], accept a 'linear no-threshold model,' which states that the less the radiation, the less the risk but there is no completely safe threshold."

Rebecca Smith-Bindman, a professor of radiology at the University of California at San Francisco, called the statement "very blasé" and "surprising," considering the source. "Ionized radiation is the most studied carcinogen in the world," she said.

Other organizations seem to agree with AAPM, however.

"We believe that risk of radiation exposure from diagnostic imaging is much less than the risk of not having the examination if the examination is diagnostically warranted," Penny Butler, senior director at the American College of Radiology, told Medicalxpress.

Radiation exposure made ECRI Institute's list of top 10 healthcare technology hazards for 2012. Both the The Joint Commission and the Centers for Medicare & Medicaid Services also have weighed in on the issue of overuse of radiation testing.

To learn more:
- read the article
- read the AAPM statement

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