Informed Consent for Radiation Risk from CT Is Unjustified Based on the Current Scientific Evidence

Harvey, H. Benjamin; Brink, James A.; Frush, Donald P.

doi:10.1148/radiol.2015142859

Cited by 39 publications

(29 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recently, multiple experts have debated the justification for having or not having a formal informed consent process for radiation risks from CT [7,47]. Some have ar-gued that a formal risk-benefit calculation is simply not possible given the current state of the scientific evidence, pointing to recent updates from atomic bomb survivor data and radiation worker studies suggesting that there is no significant increase in cancer risk from low-dose radiation exposure [7].…”

Section: Implications For Practice When Should Radiation Risks Be Commentioning

confidence: 99%

See 1 more Smart Citation

Communicating Potential Radiation-Induced Cancer Risks From Medical Imaging Directly to Patients

Lam

Larson

Eisenberg

et al. 2015

American Journal of Roentgenology

View full text Add to dashboard Cite

Despite growing concerns regarding medical radiation exposure, there is still limited awareness of radiation-induced cancer risks among patients and physicians. There is also no consensus regarding who should provide patients with relevant information, as well as in what specific situations and exactly what information should be communicated. Radiologists should prioritize development of consensus statements and novel educational initiatives with regard to radiation-induced cancer risk awareness and communication.

show abstract

Section: Implications For Practice When Should Radiation Risks Be Commentioning

confidence: 99%

“…The carcinogenic risk is cumulative over time, and there is no dose threshold below which risk is absent. However, other experts believe that the current available evidence regarding the effects of low-dose radiation is unclear and suggest that carcinogenesis requires a threshold of at least 100 mSv [7].…”

mentioning

confidence: 99%

Communicating Potential Radiation-Induced Cancer Risks From Medical Imaging Directly to Patients

Lam

Larson

Eisenberg

et al. 2015

American Journal of Roentgenology

View full text Add to dashboard Cite

show abstract

“…Although the use of CT for diagnostic imaging has increased dramatically over the years, the fear of high radiation exposure has prompted cautious use20. There is a general consensus that radiation dose that does not add value to patient care should be avoided.…”

mentioning

confidence: 99%

Effects of dose reduction on bone strength prediction using finite element analysis

Anitha

Subburaj

Mei

et al. 2016

Sci Rep

View full text Add to dashboard Cite

This study aimed to evaluate the effect of dose reduction, by means of tube exposure reduction, on bone strength prediction from finite-element (FE) analysis. Fresh thoracic mid-vertebrae specimens (n = 11) were imaged, using multi-detector computed tomography (MDCT), at different intensities of X-ray tube exposures (80, 150, 220 and 500 mAs). Bone mineral density (BMD) was estimated from the mid-slice of each specimen from MDCT images. Differences in image quality and geometry of each specimen were measured. FE analysis was performed on all specimens to predict fracture load. Paired t-tests were used to compare the results obtained, using the highest CT dose (500 mAs) as reference. Dose reduction had no significant impact on FE-predicted fracture loads, with significant correlations obtained with reference to 500 mAs, for 80 mAs (R2 = 0.997, p < 0.001), 150 mAs (R2 = 0.998, p < 0.001) and 220 mAs (R2 = 0.987, p < 0.001). There were no significant differences in volume quantification between the different doses examined. CT imaging radiation dose could be reduced substantially to 64% with no impact on strength estimates obtained from FE analysis. Reduced CT dose will enable early diagnosis and advanced monitoring of osteoporosis and associated fracture risk.

show abstract

“…This is a particularly significant issue given the mounting attention to the potential harm from ionizing radiation associated with CT. Ionizing radiation is hypothesized to increase the lifetime risk of cancer by approximately one case for every 2000 abdominal CT scans performed (22), though some have debated the true severity of harm from CT (23). Assuming that these theoretical projections are correct, up to 1.5–2% of all current cancers could potentially be related to the use of CT scans (24).…”

Section: Introductionmentioning

confidence: 99%

Trends in the Use of Medical Imaging to Diagnose Appendicitis at an Academic Medical Center

Repplinger

Weber

Pickhardt

et al. 2016

Journal of the American College of Radiology

View full text Add to dashboard Cite

Objective To quantify the trends in imaging use for the diagnosis of appendicitis. Methods Retrospective study at an academic medical center over a 22-year period. Patients were identified by ICD-9 diagnosis code for appendicitis. Medical record data extraction of these patients included imaging test used (ultrasound, CT, or MRI), gender, age, and body mass index (BMI). The proportion of patients undergoing each scan was calculated by year. Regression analysis was performed to determine whether age, gender, or BMI affected the imaging choice. Results There were 2108 patients in this study, including 967 (43.5%) females and 599 (27%) children (<18 years old). CT use increased over time for the entire cohort (2.9% to 82.4%, p<0.0001) and each subgroup (males, females, adults, pediatrics, p<0.0001 for each). CT use increased more in females and adults than males and pediatric patients, though the differences in trends were not statistically significant (male vs. female p=0.8, adult vs. pediatric p=0.1). The percentage of patients who had no imaging used for the diagnosis of appendicitis decreased over time (p<0.0001 overall and each subgroup), and there was no difference in trends between complementary subgroups (males vs. female p=0.53, adults vs pediatrics p=0.66). There were no statistically significant changes in the use of ultrasound or MRI over the study period. With increasing BMI, CT was more frequently used. Conclusion Of those diagnosed with appendicitis at an academic medical center, CT use increased over 20-fold. However, there was not a statistically significant trend towards increased use of ultrasound or MRI.

show abstract

Informed Consent for Radiation Risk from CT Is Unjustified Based on the Current Scientific Evidence

Cited by 39 publications

References 48 publications

Communicating Potential Radiation-Induced Cancer Risks From Medical Imaging Directly to Patients

Communicating Potential Radiation-Induced Cancer Risks From Medical Imaging Directly to Patients

Effects of dose reduction on bone strength prediction using finite element analysis

Trends in the Use of Medical Imaging to Diagnose Appendicitis at an Academic Medical Center

Contact Info

Product

Resources

About