Associate Professor, Tim Szczykutowicz, PhD recently served on American Association of Physicists in Medicine (AAPM) Science Council Taskforce on Cumulative Effective Dose. The Taskforce focused their efforts on creating a policy that outlines the use of allowing a patients’ prior exposure to diagnostic radiation to influence the decision to order an imaging exam.
The policy, also being adopted by the American College of Radiology (ACR) and the Health Physics Society (HPS), states, “The decision to perform a medical imaging exam should be based on clinical grounds, including the information available from prior imaging results, and not on the dose from prior imaging-related radiation exposures.”
Dr. Szczykutowicz commented in response to the policy, “I was happy to see the AAPM take this step towards stopping the use of cumulative effective dose. The concept is being proposed to allow denial of a patient from receiving the indicated imaging procedures. Current evidence points to the vast majority of medical imaging procedures inducing risks that are dwarfed by a patient’s pre-existing conditions.”
The importance of weighing all factors relative to these risks is key. Dr. Szczykutowicz further explained, “I think too often our community forgets this because of an unwarranted fear of ionizing radiation. For example, if you look at guidelines for pregnant patients presenting with PE-like symptoms, using a reduced dose CT study or sending the patient to nuclear medicine reduces diagnostic utility or adds many tens of minutes to the imaging study… all to reduce some uncertain and miniscule risk.”
You can read the full policy here: https://www.aapm.org/org/policies/details.asp?id=1533&type=PP