Beyond the CT Scan Scare

     We all know bad news sells. Turn on the news and you’ll see raging wildfires, random shootings, and drought-stricken cornfields. In the last few months, the media has spotlighted an increase in people getting larger and perhaps more dangerous doses of radiation from CT scans. Could we be getting too much of a good thing?

     Radiologist Paul Marinelli, MD, medical director of the imaging department at Meritus Medical Center recently talked to me about putting CT scans into perspective. Physicians, says Dr. Marinelli, order CT scans to look for signs of trouble in the body from a variety of causes, including cancer, heart, abdominal and lung problems, and trauma from accidents or other injuries. Sometimes multiple CT scans are needed to look for problems in different organs. But are CT scans safe? Should patients opt for another method of imaging? Dr. Marinelli clears the air on the current imaging controversy.

     Weigh the benefits versus the risks. According to Dr. Marinelli, CT scans are very sensitive to picking up diseases. “They are a great diagnostic tool and save millions of lives each year.” For example, women have a less than one-in-ten chance of developing breast cancer compared to the extremely small chance of cancer secondary to the radiation exposure. Based on this, yearly mammograms make sense, says Dr. Marinelli.

     Understand the research. Dr. Marinelli warns that the numbers about the possible effects of CT scan radiation are based on assumptions. For example, research can look at the effects of radiation on people from a nuclear disaster, but we’re unable to expose a study group of people to radiation to determine appropriate levels. What we do know is that CT scans may slightly increase the risk of developing cancer, but at low doses, the risk is very small—so small that it's difficult to prove what that risk might be.

     Ask questions. Dr. Marinelli encourages patients and caregivers to ask physicians whether an imaging test is necessary, how it will improve your care, and if the information can be obtained in other ways. Ultrasounds and MRIs, for example, can image the body without the use of radiation.

     Put yourself in the doc’s shoes. Physicians are in the business of healing. Imaging tests, like CT scans, help doctors rule out conditions and identify problems. Overlooking, or missing a defect, is not acceptable in the patient’s eyes, and therefore, there is an inherent responsibility for the physician to order imaging tests.

     Make sure your imaging facility knows what it’s doing. Meritus Medical Center has policies in place to limit imaging scans that may not be necessary. The hospital’s equipment and the machines at Diagnostic Imaging Services are regularly evaluated by physicists and radiologists to ensure that patients get the lowest possible radiation dose.

The bottom line, says Dr. Marinelli, “You can’t let headlines guide your medical care.”