Feature | March 22, 2012

Radiation Safety in Cardiovascular Care Report Released by ACC, AHA, Duke

March 22, 2012 – Addressing concerns over radiation from cardiac imaging and procedures, the American College of Cardiology Foundation (ACCF), Duke University Clinical Research Institute (DCRI) and American Heart Association (AHA)  released recommendations to enhance radiation safety.

Diagnostic imaging tests and procedures that use radiation play an important role in the effective treatment of heart disease. While there is no evidence that exposure to low levels of radiation in the course of treatment causes harm, concerns about patient safety remain.

“The use of radiation is essential to high-quality cardiovascular care,” said Pamela S. Douglas, M.D., professor of medicine at Duke University Medical School and chair of the writing committee. “Without it, we wouldn’t be able to do all the things we can now do to diagnose and treat patients, so we need to minimize patient exposure while preserving our ability to take care of this very common disease.”

Radiation exposure for medical purposes has increased about six-fold over the past 25 years, with radiation from cardiovascular imaging and interventions accounting for about 17 percent of the total. Imaging tests with radiation allow healthcare professionals to see detailed pictures of the heart to identify problems. This technology is also commonly used when patients have chest pains and in treating arrhythmias (an irregular heartbeat), and can provide real-time guidance to cardiologists during angioplasty (when implanting stents to open blocked or narrowed coronary arteries), among other applications.

The new report – a culmination of the first multidisciplinary think tank on the topic – provides a roadmap to improve radiation safety, reduce patient dose, and obtain quality images for diagnosis and treatment based on available appropriate use criteria and best practices. A broad array of stakeholders were represented including medical physicists, experts in cardiovascular imaging, safety specialists, government agencies, patients, and industry representatives who are responsible for making better equipment.

“This effort represents a major step forward to better define the issues and needs around patient radiation safety in cardiovascular imaging, and to develop an action plan to guide future efforts,” said Douglas.

Ionizing radiation has been in use for medical purposes since 1895 and recent technological advances have increased its use in cardiology. Still,  Douglas says there are gaps in many physicians’ understanding of how radiation is actually measured and what is known and unknown about the potential harm it might cause patients down the line. As such, experts say it is critical to better understand how radiation is being used and to allay concerns about exposure. A key challenge discussed by the group is that the absorbed dose – which is less than that delivered by the machine – varies tremendously from person to person, by the organ or tissue scanned, the machine design and a host of other factors.

“We need to better understand the difference between the radiation delivered (exposure) and the dose received, and try to reduce the variability across patients and across laboratories,” Douglas said. “The reality is that radiation exposure is a fact of life. We are exposed to background radiation from natural sources each and every day, and there is no evidence at this time that the low level of radiation used in most health care encounters causes any problems.”

However, she says the think tank has called for long-term tracking of those individuals most at risk, as well as the implementation of quality improvement initiatives designed to help laboratories track and improve their radiation safety.

 Among the recommendations set forth include the need for:

• Collaboration across a large number of diverse stakeholders

• Education of healthcare providers ordering and providing medical tests and procedures using radiation, including creating a culture of safety to ensure clinicians are aware of strategies that can minimize radiation exposure

• Clarification of the relationship between low-dose radiation exposure associated with cardiovascular imaging and therapeutic procedures and potential health problems or malignancies down the line

• Careful patient selection and avoidance of inappropriate testing and procedures by using ACC’s appropriate use criteria and balancing the benefits of cardiovascular testing and procedures against minimizing dose, including adherence to the long-standing principle of ALARA—as low as reasonably allowed. 

 

In addition to ACCF, DCRI and AHA, other participating societies included the American College of Radiology, American Society of Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society of Nuclear Medicine.

The full report, “Developing an Action Plan for Patient Radiation Safety in Adult Cardiovascular Medicine,” will be published in the May 15, 2012, issue of the Journal of the American College of Cardiology and an upcoming issue of Circulation: Journal of the American Heart Association. It will also be accessible at www.cardiosource.org.

 

Related Content

Doctor-Patient Discussions Neglect Potential Harms of Lung Cancer Screening
News | Lung Cancer | August 15, 2018
August 15, 2018 — Although national guidelines advise doctors to discuss the benefits and harms of...
Guerbet Partners With Imalogix on Dose Optimization With Artificial Intelligence
News | Radiation Dose Management | August 14, 2018
August 14, 2018 — Guerbet LLC USA announced a commercial partnership with Imalogix, a provider of...
ACR LI-RADS Steering Committee Releases New Version of CT/MRI LI-RADS
News | Clinical Decision Support | August 13, 2018
August 13, 2018 — The American College of Radiology Liver Imaging Reporting and Data System (LI-RADS) steering commit
PET Tracer Identifies Estrogen Receptor Expression Differences in Breast Cancer Patients
News | PET Imaging | August 09, 2018
In metastatic breast cancer, prognosis and treatment is largely influenced by estrogen receptor (ER) expression of the...
Aidoc Receives FDA Clearance for AI Detection of Acute Intracranial Hemorrhage
Technology | Clinical Decision Support | August 08, 2018
Aidoc announced that it was granted U.S. Food and Drug Administration (FDA) clearance for the first product of its...
Imalogix Brings Fluoroscopy Capabilities to Radiation Dose Management Platform
Technology | Radiographic Fluoroscopy (RF) | August 06, 2018
Imalogix, a provider of artificial intelligence (AI) process and workflow solutions, announced the availability of the...
Novel PET Imaging Method Could Track and Guide Type 1 Diabetes Therapy
News | PET Imaging | August 03, 2018
Researchers have discovered a new nuclear medicine test that could improve care of patients with type 1 diabetes. The...
Hologic Acquires Digital Specimen Radiography Company Faxitron Bioptics

VisionCT 3-D breast specimen-designated computed tomography (CT) system. Image courtesy of Faxitron Bioptics.

News | Breast Imaging | July 31, 2018
Hologic Inc. announced it has completed the acquisition of Faxitron Bioptics, a privately-held leader in digital...
Varian Showcases Advanced Cancer Care Solutions at AAPM 2018
News | Radiation Therapy | July 27, 2018
Varian announced it will be showcasing its advanced cancer care solutions, including a new version of the Eclipse...
Overlay Init