The American Heart Association (AHA) has issued a science advisory on ionizing radiation and the experts’ message was clear: be prudent when using heart imaging diagnostic tests to minimize patient exposure to ionizing radiation.
The advisory entitled Ionizing Radiation in Cardiac Imaging. A Science Advisory from the American Heart Association…was recently published in this week’s issue of the AHA journal circulation. Diagnostic tests which use ionizing radiation are
- computed tomography (CT) scans
- fluoroscopy (e.g. an angiogram)
- radionuclide studies.
According to the AHA advisory
- Medical radiation exposures of the US population have increased by more than 700% between 1980 and 2006.
- CT has had an annual growth rate of more than 10% and accounted for about 50% of the collective dose in 2006.
- About 65% of the collective CT dose is from studies of chest, abdomen, and pelvis; cardiac CT scan accounted for 1.5% of the collective CT dose and this is expected to rise.
- In 2006, cardiac imaging represented 57% of nuclear medicine studies.
In recent years, the use of CT in diagnostics has become popular. Many diagnostic centers in the US are offering so-called “wellness scans” using CT scanners. The Medical City Dallas Hospital in North Texas wellness scan is “a non-invasive CT test from the collarbone to the pelvis and covers the heart, lungs and abdomen. The specific areas scanned in the abdomen are the kidneys, liver, gall bladder, aorta, adrenal glands, lymph nodes, spleen and other certain pelvic organs.”
The Diagnostic and Wellness Center at Harbor-UCLA offers a heart scan, lung scan, abdominal aorta scan, carotid artery scan, or a body scan which includes all of those previously mentioned plus scans of organs in the abdominal and pelvic area to screen for cardiovascular disorders and cancer.
Could it be that too many unnecessary CT scans are actually being done in the name of health and wellness?
The AHA guidelines emphasize that although the risk of developing cancer from ionizing radiation tests is rather low, these tests should nevertheless be only performed after careful consideration of the benefits and the necessity of the tests.
To avoid unnecessary exposure, here are some recommendations for the health care providers:
- Physicians should carefully review a patient’s medical records, including those from other doctors and doctors, to make sure that imaging tests are not needlessly repeated.
- When performing a test, use the lowest dose possible.
- The use of radionuclide tests or cardiac CT scans in low risk patients without any symptoms is discouraged.
Finally, the AHA states that