New System to Measure and Report Cumulative Medical Radiation Exposure

At Intermountain Healthcare we are compiling the cumulative radiation patients receive from about 220,000 higher-dose procedures and imaging exams each year, starting with exams performed in the last quarter of 2012. That information is now readily available to both physicians and patients. Physicians and other medical personnel can review the cumulative radiation a patient has received through Intermountain’s electronic medical record system. Patients can view their own radiation history by signing up for Intermountain’s free “My Health” program. In addition to providing the cumulative radiation history, patients and physicians are also given access to educational materials on the risks and benefits of medical radiation.

We're excited to begin to see the benefits of monitoring cumulative radiation. With this information, clinicians and staff have reduced radiation, avoided unnecessary treatments, and found alternatives which do not involve x-rays.

While a patient’s individual situation typically dictates the imaging procedure needed, being able to see a patient’s cumulative radiation exposure can help caregivers determine which type of imaging test is best. The benefits from a procedure usually outweigh the slightly increased cancer risk from exposure to radiation, but the potential risk of radiation should be considered before these imaging tests are performed.

Having such information available is especially helpful for children with certain chronic health problems, as they may need to have many tests involving radiation during their lifetime. The cancer risk from an imaging test is lower the older a person gets, and the highest risk is for children.

Nationally, much of the clinical movement to decrease radiation exposure has emerged from the pediatric radiology community, and radiologists from Primary Children’s Medical Center have actively contributed to this effort. For example, Primary Children’s is one of six pediatric hospitals nationally participating in a study to establish benchmarks for appropriate radiation exposure in pediatric CT exams. The commitment to reducing dose is an ongoing commitment of Intermountain Healthcare to patients at all its facilities.

Images created using radiation provide important information about a patient’s health. They are often needed to help doctors and other health professionals diagnose a problem or treat it in the best way. Imaging tests using radiation include CT scans, angiograms, nuclear medicine heart tests, mammograms, x-rays, and bone density scans. MRI and ultrasound exams do not use radiation to produce an image.

Most medical imaging tests add only a small fraction of radiation exposure when compared to natural sources of radiation. For example, a chest x-ray uses about the same radiation as living in your natural surroundings for about 10 days. There isn’t consensus among experts about the magnitude of cancer risk, but doctors agree patients shouldn’t be exposed to any more radiation than necessary.

Still, when a CT scan or another imaging test is deemed necessary, patients should get it. The radiation doses are not significant enough compared to the benefit of extending lives, saving lives, and improving the quality of lives.

Sharing the cumulative radiation number with patients and their healthcare providers is just one of many steps Intermountain takes to increase safety with medical radiation. Intermountain has also partnered with GE Healthcare to develop techniques that help further reduce radiation doses from CT scans by up to 50 percent, while still maintaining a high-quality image.

Post authors:
Donald Lappé, MD, medical director of Intermountain’s Cardiovascular Clinical Program.
Keith White, MD, medical director of Intermountain’s Imaging Services.​