The number of unnecessary advanced imaging exams (CT, MRI, and nuclear medicine) -- as well as patient radiation dose -- can be significantly reduced by educating referring physicians about the risks, benefits, and alternatives of various imaging modalities, according to a pair of studies to be presented at next week's American Roentgen Ray Society (ARRS) meeting in Boston.
In the first study, lead author Dr. Joseph Platnick of Staten Island University Hospital in Staten Island, NY, wrote that a program targeted at educating referring clinicians on the benefits and risks of advanced imaging led to a 26% reduction in the number of imaging studies ordered, with an 18% reduction of CT scans in the study period.
"While advanced imaging certainly plays a major and necessary role in patient care, there are times when studies are not needed," Platnick said. "Eliminating these studies is imperative to control the ballooning costs of healthcare without compromising on healthcare."
In the second study, lead author Dr. Linda Haramati found that educating physicians about ventilation/perfusion (VQ) scanning as an alternative to CT for diagnosing pulmonary embolism led to a 23% decrease in patient exposure.
Haramati and colleagues from Albert Einstein College of Medicine at Montefiore Medical Center in New York City said that CT delivers a much higher radiation exposure than nuclear medicine-based VQ scans. But VQ scans are harder to interpret in patients with abnormal chest x-rays, so Montefiore clinicians have decided to perform VQ scans as the preferred imaging modality in patients with normal chest x-rays who were suspected of having pulmonary embolism to decrease radiation exposure.
The group found that in 2006 approximately 60% of pulmonary emboli exams were CT, whereas in 2007, after adopting the new diagnostic algorithm, about 60% of studies were VQ and mean effective dose was reduced by 23%, from 11.5 mSv in 2006 to 8.9 mSv in 2007.
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