Question

Recognizing that there is much discussion amongst consumers as to the dangers of the use of technology in radiology, identify what questions consumers should be asking before agreeing to a CT sca​n

Answer 1

• A computerized tomography (CT) scan combines a series of X-ray images taken from different angles around your body and uses computer processing to create cross-sectional images (slices) of the bones, blood vessels and soft tissues inside your body. CT scan images provide more-detailed information than plain X-rays do.
• A CT scan has many uses, but it's particularly well-suited to quickly examine people who may have internal injuries from car accidents or other types of trauma. A CT scan can be used to visualize nearly all parts of the body and is used to diagnose disease or injury as well as to plan medical, surgical or radiation treatment.
• During a CT scan, you're briefly exposed to ionizing radiation. The amount of radiation is greater than you would get during a plain X-ray because the CT scan gathers more-detailed information. The low doses of radiation used in CT scans have not been shown to cause long-term harm, although at much higher doses, there may be a small increase in your potential risk of cancer.
• Doctors need to do a better job educating their patients about the risks and benefits of any medical imaging test, and should welcome questions from their patients.
• Patients should come prepared with a set of questions to ask their doctor each time they are recommended an imaging test.

1. Why is the test necessary?

You should never refuse a test if it’s needed. But they’re often not. Ask why the test is being done, how the results will affect your treatment, and what will happen if you skip it.

2. Is there a safer alternative?

Ultrasounds or magnetic resonance imaging (MRI), which don’t expose you to radiation, can sometimes be used instead.

3. Is your doctor credentialed?

Ask whether the radiology facility is accredited by the American College of Radiology, (the ACR’s accreditation process addresses dose and image quality, unlike some other accreditors), whether the CT technologists are credentialed by the American Registry of Radiologic Technologists, and whether the person interpreting the studies is a board-certified radiologist or pediatric radiologist. Also check to see whether the radiology professional, imaging facility, or referring physician has joined efforts to reduce the overuse of medical imaging, such as Image Gently, which focuses on children, and Image Wisely for adults.

4. Has your doctor invested in a CT scanner or radiology clinic?

An in-office CT scanner may seem convenient, but it carries an inherent financial conflict of interest. And studies show that physicians who own scanners use imaging much more than those who refer their patients to out-of-office radiology centers. So ask your doctors whether they are referring you to a machine or an imaging center that they have a financial interest in.

5. What’s the right dose for me?

The smaller or thinner you are, the lower the radiation dose you need. The circumference of your chest, hip, thigh, or waist can also change the dose.

6. Do you have a prior scan?

If you recently had an X-ray or a CT scan of the same area, ask whether your doctor can use that instead. And ask for CDs of your scans, for future visits.