RE: News Article: Patients, Physicians Unaware of CT Radiation Exposure

[osuleiman@comcast.net]

The fundamental problem is that ALARA is not practiced, i.e. how can one give a patient as low as reasonably achievable when many do not even know the radiation dose.



Most medical exams can be justified on an individual basis, even a 10 mSv effective dose, which is on the high end, but when one uses the risk estimates for cancer, applied to millions of patients, the numbers can be perceived as high.



The debate over LNT is a waste of precious energy, theoretically one photon can result in a cancer, period.  Are there modifying factors, yes, it's also called biological variability, radical scavengers, immune response, genetic predispoistion, dose rate, soft epidemiological data upon which risk estimates are based, the list is endless, but theoretially one photon could result in a cancer.



I think it is long overdue, but there really should be a coordinated demand for everyone to actually know the radiation dose individuals receive from a specific exam, be it nuclear medicine or x-ray.  The science exists.



Radiation in Medicine is a valuable tool, and so is the scalpel, both are also hazardous.

> The statement should be that there are no demonstrated

> effects below 10 rem, which does not mean there are

> none.  In certain subpopulations, like children, there

> may be greater risks.  CTs are producing the greatest

> exposures in radiology.  Its use had been doubling,

> and imaging is replacing some medical procedure. 

> Consider that surgical laparotomy exams are no longer

> done for suspected appendicitis.  CT exams with a dose

> of 10 mSv are providing the evaluations. 

> 

> "While the number of visits (to the Emergency Room)

> remained stable throughout the reporting period, the

> use of head CT increased from 23.9% to 46% between

> 1992 and 2000 (p=0.001). In addition, head CT was used

> more frequently in the older age groups: Children 0-4

> years of age had 15.9% of the scans, children 5-10

> years of age had 37.7% of the scans, and patients

> 11-18 years of age had 45.9% of the scans, he said."

> 

> The fuss is that 1 rem plus 2 rem plus . . . add up to

> significant doses in some patients.

> 



> I would also suggest you invest in companies that make

> CT and PET scanners.

> 

> --- "Franta, Jaroslav" <frantaj@AECL.CA> wrote:

> > It would not be uncommon for a patient to get more

> > than 50 mSv (5 rem).  

> > <SNIP>

> > 

> > I thought that the current thinking was that no

> > detrimental effects can be

> > supported scientifically for any dose less than

> > about 10 rem.

> > If that's the case, than why all the fuss about 1

> > rem CT doses ?

> > 

> > -----------------

> > 

> > 

> > 

> > As far as I know, there is no debate about DECREASED

> > risk of cancer in the medical profession.  It only

> > appears on this list server.

> > 

> > --- "Franta, Jaroslav" <frantaj@aecl.ca> wrote:

> > > Thanks John, this is interesting.

> > > 

> > > Regarding the statement, 

> > > "Given the current debate about the possible

> > > increased cancer risk

> > > associated with diagnostic CT scans,...... we

> > > believe that it is important

> > > that the radiology community make current

> > > information regarding CT radiation



> > > dose more widely available."

> > > 

> > > I thought the "current debate" was about the

> > > possible DECREASED cancer risk

> > > associated with low dose radiation ?

> > > (they seems to be talking about a debate 20 to 40

> > > years ago....)

> > > 

> > > Regarding,

> > > "Nearly half the radiologists (47%) believed that

> > a

> > > CT scan increased the

> > > lifetime risk of cancer"

> > > 

> > > ....seems to suggest that there might be a problem

> > > if these radiologists are

> > > asked to "make current information regarding

> > > radiation widely available...."

> > > 

> > > Jaro 

> > > 

> > > 

> > 

> 

> 

> =====

> +++++++++++++++++++

> "We cannot escape danger, or the fear of danger, by crawling into bed and 

> pulling the covers over our heads."

> -- Franklin Delano Roosevelt

> 

> -- John

> John Jacobus, MS

> Certified Health Physicist

> e-mail:  crispy_bird@yahoo.com

> 

> 

> 	

> 		

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