Most imaging studies involve the use of radiation ions in order to peer into the human body and make a diagnosis. However, radiation exposure carries potential risks. Now, thanks to changes in technology and techniques, lower dose procedures are available. Dr. Elaine Gould, Interim Chair of the Department of Radiology for Stony Brook Medicine, talks about what this means and how it works.
First, could you explain the role of radiation in imaging studies?
Imaging uses either ionizing or non-ionizing radiation. Non-ionizing radiation, which is used in ultrasound, carries very little risk. Ionizing radiation, which is used in X-rays, CT scans and nuclear medicine studies, has a theoretical risk of being linked to cancer. No one knows exactly what the radiation threshold is, so it makes sense to minimize the dosage in imaging tests. The older you get, the less sensitive your body is to radiation, so it is particularly important to limit radiation exposure in children, teens and young adults whose bodies are still developing.
How can you limit the dosage?
There are three ways: One is to perform imaging studies only when it will improve patient care and outcomes. Another is to use non-ionizing radiation technology whenever possible. And a third is when using ionizing radiation technology, to use the lowest dose possible.
What are the technology and techniques for lowering radiation dosage?
You can either lower the dosage by programming a computer algorithm into the software that runs the imaging equipment or through the way the radiologist designs the exam. Employing both is optimal, which is the way we do it at Stony Brook.
Why isn’t this more commonly done?
Many facilities use the dosage-lowering software — as long as they have equipment that is compatible with the available software. Since the low-dose programming has mostly developed over the past five to six years, the newer the equipment, the higher the odds of being able to use this highly specific software. Having the radiologist redesign the exam, however, is a different story. This is enormously dependent on the skill and experience of the radiologist, as well as the commitment of the institution at which they work. Low-dose images look different. It is the radiation that brings out the visible characteristics in the image, so the higher the dosage, the easier it is to read the scan, and read it quickly. Reading reduced dose scans takes training and experience in order to read accurately. It also takes more time, so hospitals that outsource their radiology readings to an off-site service may not be able to offer the low-dose option because these services depend on moving a high volume of scans through the system hourly.
How does Stony Brook handle it?
Every piece of ionizing imaging technology at Stony Brook is equipped with the software that programs low doses. As an academic medical center, we tend to get the most advanced equipment in the region first, so actually we have been offering this for some time now. In addition, our radiologists — who, I might add, are among some of the best in the country — have all been trained in performing low-dose exams, and take their time with them. We work on the concept of not getting the “best” image (because sometimes that requires more radiation) but the best image for that patient in order to clearly and accurately read the scan. As a result, the dosage on a typical imaging exam today is one quarter of what it was five or six years ago.
For more information about Stony Brook Medicine’s Imaging Services, call (631) 638-2121.
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