Radiologists, radiographers must collaborate to minimize patient exposure levels

With the recent attention paid to the issue of medical radiation, most observers have focused on lowering CT dose. But the sheer number of radiographic exams performed in the U.S.--74 percent of the all radiologic exams, according to a new white paper released by the American Society of Radiologic Technologists--means attention should be paid to the practice of digital radiography, as well.

There's no question that computed radiography and direct/indirect digital radiography provide a host of advantages lacking in film radiography, including the wider dynamic range exhibited by CR/DR. But, associated with those benefits is a disadvantage--the phenomenon of exposure, or dose creep.

Unlike film radiography, overexposure with digital radiography actually improves image quality. One of the theories behind the idea of dose creep is that radiographers tend to choose higher exposure levels because it will increase image quality and, correspondingly, lead to fewer complaints from radiologists.

While there's been plenty written about how best practices involving digital radiography should be pursued, little of it has actually come from radiographers. The ASRT CR/DR Task Force's white paper, "Best Practices in Digital Radiography," changes that.

"We really feel that a document for radiographers, created by radiographers, is necessary to improve the practice," Tracy Herrmann, a professor and radiologic technology program director at the University of Cincinnati Blue Ash College, and head of the ASRT task force, told FierceMedicalImaging.

It's certainly appropriate that radiographers should take steps to promote best practices when it comes to DR/CR. After all, they are considered to be the experts on exposure technique within their radiology teams.

We also should expect radiographers to stay up to date in their chosen field and to continue educating themselves about exposure techniques and equipment. What's more, there's plenty that non-radiographers should be doing, as well. Industry groups and vendors, for example, should continue to work to standardize exposure index values.

And administrators, physicists and radiologists should be working with radiographers to implement and support best DR/CR practices at their institutions.

While radiologists don't like noise in images, they need to collaborate with radiographers to minimize dose while maintaining the image quality needed to come up with a correct diagnosis.

It's the kind of collaborative effort that can only help but improve the practice of digital radiography.

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