Striking a balance in the discussion of the benefits of imaging tests and risks of radiation exposure

Abstract

Diagnostic testing from ionizing radiation is an integral part of the practice of medicine. The therapeutic advances and substantial improvement in the care of patients with cardiovascular diseases would not be possible without the concomitant advances in cardiovascular imaging that have occurred. Indeed, the testing that we perform can be lifesaving, although indirectly. This point is sometimes forgotten in the consideration of risks and benefits. In the case of heart disease, there has been a dramatic improvement in patient outcome. 1 It is hard to imagine that this would have occurred without accurate diagnostic testing. Recently, a comprehensive review of the subject of the optimal use of ionizing radiation in cardiovascular imaging was published in the Journal of the American College of Cardiology. 2 There is superb content in this paper and the authors should be applauded for bringing together so much information on this complicated subject. The review serves as an effective educational tool for radiation terminology, the principals of best practice, and the various potential dangers of ionizing radiation. The American Society of Nuclear Cardiology (ASNC) was invited to be a signatory to this publication. However, the ASNC Executive Council, Board of Directors, and Quality Committee voted to refrain from endorsing the document, for 3 reasons.