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RE: News Article: Patients, Physicians Unaware of CT Radiation Exposure
I would say that ALARA is not associated with medical
treatment. The issue is risk (death from head injury)
v. increased risk of cancer (current rate of 25%) in
20 to 50 years. Efforts have been made in the last
five years or so to reduce CT exposures by adjusting
the output of the units, so a 10 year-old does not
receive the exposure that a 30 year-old does.
I certainly believe that there is little use in
arguing about the LNT. Your comments are valid and I
agree with them. Biololgy is not like physics.
Variability is hard to control.
However, in medicine as well as other profession,
judicious use of services should be followed. Not
everyone who gets hit in the head with a baseball
needs a CT scan. Unless the person is a multi-million
dollar professional player, where you are more
concerned with an "investment."
There is an effort to record patient exposure
information for evaluating risk from high fluoro
procedures http://www.fda.gov/cdrh/xrayinj.html There
is a "recommendation" by the FDA for each patient to
keep a record their own x-ray exams
http://www.fda.gov/cdrh/consumer/xraybrochure.html#7
but I do not know of anyone who does.
--- osuleiman@comcast.net wrote:
> 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
> >
> >
> >
> >
> > __________________________________
> > Do you Yahoo!?
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> >
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> >
>
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=====
+++++++++++++++++++
"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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