Main Line Health Radiology Introduces Pioneering Safety Measures
By Harry G. Zegel, MD, FACR, System Chairman, Department of
Radiology, Main Line Health
(July 2010)—There has been much concern in recent days regarding the
potential danger of radiation received through medical
testing—specifically, through the increased utilization of CT scans. The
benefits of diagnostic imaging are immense. Medical imaging, and
especially CT, is a powerful tool that has significantly contributed to
improved patient diagnosis and clinical outcome. Current technology
allows us to observe lesions that are smaller, and with greater
confidence than ever before.
However, in all situations, the diagnostic benefits of any ordered
examination need to be considered, particularly when involving
radiation, in their clinical context. While there is no defined safe
threshold regarding low levels of radiation associated with diagnostic
examinations, the delay, or worse, the failure to obtain a medically
necessary examination, and the undesirable consequences that this
incurs, must be balanced against the very small radiation risk posed by
the study. Proper selection of the appropriate diagnostic examination is
indeed a complex decision that begins with the patient and his or her
physician. Additionally, the radiologist, guided by criteria established
by the American College of Radiology, can assist in this process. When
an examination is ordered, it should be performed safely and interpreted
At Main Line Health, we’ve been focused on the issue of appropriate
radiation levels for several years, and have taken numerous steps to
ensure the safety of our patients.
Education is extremely important. Over the last year, every Main Line
Health physician has been notified regarding the concerns of radiation
and appropriate diagnostic inquiry. Formal educational presentations
have occurred repeatedly at all four of our acute care hospital
campuses. In all of our facilities, we employ Board Certified
Radiologists who are available to confer with our physicians at any time
regarding diagnostic alternatives. Similarly, all of our technologists
comply with their organization’s level of required competence.
In 2009, Main Line Health introduced a pioneering safety initiative to
minimize radiation exposure to patients who receive frequent radiologic
studies. As reported on June 14, 2010, the Food and Drug Administration
is in the process of implementing policies documenting the total
radiation dosage a patient receives during an imaging examination.
Throughout Main Line Health, we already record the amount of actual CT
exposure and fluoroscopic radiation time for every patient we serve, and
notify physicians when an out patient has received more than five CTs at
a Main Line Health facility within the past two years. When these
examinations are requested in the Emergency Department, a dialog box
alerts the physician in real time.
We also are extremely proud that Main Line Health has taken the
additional step to upgrade CT scanners throughout our system to reduce
radiation up to 50 percent in comparison with standard multi-slice CT
Equally important, we’ve instituted low-dose protocols for all of our
medical imaging, ensuring that we are always utilizing the lowest
dosages of radiation possible in order to garner the appropriate images.
This is known as the ALARA principle—as low as reasonably achievable.
In addition to our Radiologists, our technologists’ are involved in the
quality assurance processes, and we routinely have outside application
specialists and additional radiation physicists review our equipment and
procedures to ensure that they are operating optimally, safely, and at
the lowest appropriate dosage.
We’re proud that all aspects of our work in medical imaging meet or
exceed the requirements established by the American College of
We have a robust Radiology Residency Program, and are committed to
educating the next generation of radiologists to deliver the safest
possible medical imaging and diagnostic services to patients.
We at Main Line Health believe strongly that the correct checks and
balances need to be in place to protect patients at all times,
particularly in regard to radiation concerns, and we are pleased to
share this information with you.
For more information, call 1.866.CALL.MLH.