Getting the Word Out
"Nothing in life is to be feared. It is only to be understood. Now is the time to understand more, so that we may fear less." — Marie Curie
Fear of radiation has been around since the discovery of this game-changing process. And as Madame Curie knew, understanding is the key to overcoming that fear.
In recent years, both scholarly journals and the media have brought to the forefront issues related to the risks of radiation. Patients are bombarded with sound bites about the harmful radiation used in medical imaging, but few have time to dig beneath the surface of the ten o'clock news to truly understand the details. Fear is prevalent, and the facts are not often well addressed by the lay press.
Unfortunately, our referring physicians are often no more certain that their patients about the relative risks of different radiological procedures and have little time to discuss these risks with a radiologist. Many radiologists also don't have the time to sift through seemingly limitless literature on radiation dosimetry and risk analysis. If you need to know about radiation risk, who are you going to call? Radiologists and radiation oncologists turn to their medical physicist colleagues to obtain a detailed understanding of issues related to radiation dose and related risks from radiological procedures so that these risks can be put into perspective. In the American College of Radiology, medical physicists are contributing to many projects related to educating patients, physicians, radiology professionals, and others about radiation dose and safety related to medical imaging.
Perhaps the most difficult task is educating patients about the risks and benefits of radiation in imaging without creating contention. There should be as much emphasis on how the subject is presented as on the information itself. To help present the material in a non-threatening, informative way, the Committee on Education under the Commission on Medical Physics is working with the Commission on Education and the RadiologyInfo.org website and app. The committee has helped develop patient-centered resources that explain the benefits and risks associated with radiology in accessible question-and-answer videos. About a dozen videos are currently on the RadiologyInfo.org website, with more on the way. (View them at http://bit.ly/BenefitsAndRisks.) Videos address such questions as, "How much medical radiation is too much?" "What are the benefits of CT scans?" and "How big is the risk from medical imaging to future generations?"
When referring physicians consider which exam is most appropriate for a patient's condition, the decision-making process includes how much, if any, radiation is involved. Medical physicists in the ACR, working through the commission's Safety Committee, have contributed to the development of the ACR Appropriateness Criteria® by providing dose information in a simple but meaningful way, using a five-point scale to aid physicians in their decision-making processes. The dose table is integrated to all applicable ACR Appropriateness Criteria® and can be found at http://bit.ly/DoseTable.
Awareness of Radiology Professionals
Understanding radiation dose and risk is important. Equally important is knowing how well we are doing when it comes to managing patient doses. The Committee on Guidelines and Standards, under the Commission on Medical Physics, is currently revising the Practice Guideline for Diagnostic Reference Levels in collaboration with the American Association of Physicists in Medicine. This revised standard will enable individuals to compare their practice's doses with the latest information from other national trends. ACR medical physicists have also been working with the Commission on Quality and Safety's Committee on Dose Registry to continuously improve the highly successful ACR Dose Index Registry®. Currently, the Dose Index Registry provides facilities with the ability to compare CT dose index data for their patients against data for the rest of the radiology community. Addition of dose indices for digital radiography and computed radiography are planned to be added by the end of the year. Plans are also underway for the registry to address dose indices in interventional procedures in the future.
Patients are not the only ones who receive radiation dose. Radiation safety for personnel and the general public are also concerns in radiology. Frequently, radiologists are asked to be radiation safety officers either within their own practice group or for larger medical institutions. At the most recent AMCLC, the Commission on Medical Physics, together with the Commission on Education, was tasked with developing training materials to help radiologists better understand this role. A workgroup under the Commission on Medical Physics' Committee on Education has undertaken this task and will be developing online training materials as well as presentations suitable for classroom or personal learning.
The number of medical physicists in the ACR may be small, but these members are involved in many vital projects in which technical understanding is important to improving quality and safety in radiological imaging.
By Richard A. Geise, PhD, FACR, Chair, Commission on Medical Physics