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 accurately.
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% in comparison with standard multi-slice CT scanners.
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 Radiology.
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.