In a white paper on radiation dose in medicine, the ACR
stated that the organization should encourage practices
to make routine reviews of patients’ detailed imaging
histories a standardized policy.
establish, follow, and document policies
and protocols aimed at optimizing radiation exposure while maximizing image
quality when performing CT examinations. 13, 19
Efforts to educate healthcare providers,
including radiologists, radiologic technologists, medical physicists, and ordering
physicians, have improved awareness of
radiation safety. 2, 20 The Alliance for Radiation Safety in Pediatric Imaging’s Image
Gently campaign, which is dedicated to
providing safe, high quality pediatric imaging throughout the United States, first
focused on CT scanning. 21 Its education
campaign sought to reach medical professionals, along with parents and the general public. The campaign provides CT
scan protocol recommendations for radiologists, radiologic technologists, medical
physicists, and referring physicians. 22 The
ACR also offers accreditation for CT scanners, a voluntary action for hospitals, or
those who do not bill for Medicare under
the part B fee schedule. 23
Regular quality control tests of all
diagnostic imaging equipment should
be performed and results should be recorded, along with a description of the
test procedures, the staff performing the
tests, and test results. Information on
equipment and technique parameters
and acceptability limits for testing also
should be maintained. A radiologist is
responsible for the overall quality control
program, but specifics of quality control
efforts and implementation should be
supervised by a qualified medical physicist as directed by local and state regulations. 19 The Joint Commission and ACR
also recommend that quality control
and preventive maintenance activities be
performed in accordance with the equipment manufacturer’s specifications. 7, 19
Another way to control rising radia-
tion exposure from medical imaging is to
address utilization of imaging examina-
tions that use ionizing radiation. In 2006,
approximately 70 million CT scans were
performed in the United States. 6 One
study found that as many as one quar-
ter of CT scans performed in the United
States are either medically unnecessary
or performed for nonmedical reasons,
such as medical-legal considerations or
poor communication among staff. 20