Reducing Radiation Exposure Without Reducing Quality
The University of Michigan’s Department of Radiology is committed to lowering radiation exposure for our patients. From utilizing the latest equipment for quicker studies to performing patient exams at the lowest radiation exposure necessary, your safety is our priority.
What You Should Know About Radiation
- While no large-scale studies on cancer risks from diagnostic radiation exist, data from the Japanese A-bomb survivors exposed to low levels of radiation suggests that frequent exposure to the low levels of radiation may increase the risk of eventually developing cancer, particularly if the person is young.
- Radiation is often measured in units known as sieverts. A threshold typically used is 100 thousandths of a sievert, or 100 millisieverts (mSv). Below 100 mSv, don’t worry; above that number, we think you’re at increased risk. Our average radiation dose at the Univeristy of Michigan is now 9 mSv.
- Patients should look for an imaging facility that is accredited and physicians who are board-certified, which will increase chances for the best study at the lowest dose.
- You don’t have to have any examination recommended. However, it’s a tradeoff: If you get the exam, you get the diagnostic information needed. If you don’t get the exam, you save the radiation, but don’t get the diagnostic information.
- The most important message regarding radiation is that of relative risk. Patients are virtually always better off having a needed imaging study than avoiding the modest radiation associated with it.
Taking Big Steps to Lower Radiation for Our Patients
We have pursued several important measures to minimize radiation exposure without sacrificing image quality, including:
- Our Physics Quality Control Group works in conjunction with radiologists and technologists to identify and purchase imaging systems with features that minimize radiation dose.
- Digital X-ray detectors, special X-ray beam filters, and other new technologies reduce radiation doses in radiography, mammography, and fluoroscopy.
- Utilize more sensitive nuclear medicine imaging equipment (such as single photon emission computed tomography and positron emission tomography scanners) lets us use smaller doses of radiotracers (a radioactive molecule used in certain imaging tests to help find problems in the body).
- We limit the region of the body being scanned/ x-rayed to the smallest possible area.
- Test all systems to ensure they’re performing correctly.
- Focus on ways to further reduce radiation exposure through ongoing research with our Engineering Department.
Lowering Radiation from CT Scans
CT (computed tomography) studies – known as a CT scan or CAT scan – have skyrocketed in popularity because they are an extremely effective tool in the diagnosis and management of disease, utilized for everything from identifying areas of the brain affected by strokes and head injuries, to detecting abnormalities of the lungs, to diagnosing abdominal diseases such as appendicitis, to assessing coronary artery disease. In ERs, CT exams are the tool of choice because of their speed and diagnostic accuracy.
Measure we take to reduce radiation from CT scans include:
- Customizing the scanning based on the size and weight of the patient or the body part being scanned.
- Eliminating unnecessary exams.
- Investing in CT scanners with the latest hardware and software tools that minimize radiation exposure. We utilize the General Electric Discovery CT750 HD, which provides up to a 50% lower dose of radiation for our patients, along with high-definition image quality for any part of the body.
- Our Radiation Exposure Registry, currently in development, will provide benchmarks for determining the optimal level of radiation for each CT exam.
- In a Blue Cross Blue Shield quality improvement study of 40 hospitals and imaging practices, called the Advanced Cardiovascular Imaging Consortium, our Cardiac Computed Tomography team reduced our average CT radiation exposure by 43 percent.
- Utilizing MRI or ultrasound, if either is considered an effective alternative.
Accreditation Is Important for Radiology Centers
Always ask if the imaging facility has been accredited. The Centers for Medicare and Medicaid Services has approved three bodies to accredit diagnostic imaging programs: the American College of Radiology, the Intersocietal Accreditation Commission and The Joint Commission. (Only one of the three accrediting bodies is required to accredit a facility.) There are five requirements for accreditation:
- Personnel qualifications for non-physician medical staff, medical directors, and supervising physicians
- Image quality
- Equipment performance
- Safety standards for staff and patients
- Quality assurance and quality control
So far, this accreditation process is mandatory for outpatient facilities only, but it is very likely to become mandatory for hospitals, too. The University of Michigan has received American College of Radiology accreditation for many of our facilities already, both in the outpatient setting and at the hospital. Soon, all of our facilities will be accredited.