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Addition to Health Visions February 2007

Maintaining a Safe Environment

From the Imaging Services Department


Patients often ask about the radiation exposure of various imaging studies and how much exposure is safe. Safety for patients and caregivers alike are top-of-mind concerns for doctors and technologists in the field of imaging and radiation services. Stringent departmental quality assurance requirements, along with regular inspections and outside audits, help to ensure the safest possible environment.


Can you put the issue of radiation exposure into perspective for us?


Everyday we are exposed to background radiation from our environment, from sources such as sunlight and radon. And while it’s true that radiation from x-rays, in general, can be dangerous, this is typically only in doses well above those used in imaging studies. One way to think about this is that a chest x-ray is equivalent to 10 days of background exposure, according to the RSNA (Radiation Society of America) web site.


What types of measures are in place to ensure radiation dosage safety?


We have many checks and balances in place. At Cayuga Medical Center, we employ a physicist group to work closely with our radiologists. These physicists routinely monitor our equipment and mammography units throughout the year to assure proper functioning. Whenever we install new imaging equipment, they perform acceptance testing after the equipment is set up, before routine patient use.


At all three of the Imaging Department sites (Cayuga Medical Center and Convenient Care Centers at Ithaca and Cortland), our radiologists and radiologic technologists are trained in physics. We operate using the ALARA (as-low-as-reasonably-achievable) principle: using as low a dose as possible, but remembering that too low a dose compromises the quality of the image, resulting in non-diagnostic imaging and useless exposure to radiation. In addition, the Radiation Safety Committee meets four times a year, to review safety measures, adherence to policies, and licensure to ensure quality assurance.


What about exposure from repeated imaging studies?


Sometimes patients need repeated studies to evaluate the efficacy of treatment or the progress of disease, and they fear excessive exposure. Women undergoing annual mammograms often ask about this. Questions about repeated exposure are difficult to answer definitively, and some advanced imaging modalities do expose the patient to a higher dose of radiation. In these cases, the patient and his or her doctor need to weigh the risks of doing the study against the risks of not doing the study and having a disease go undiagnosed while it is possibly in its early, most treatable stage.


What about children and babies?


Parents concerned about children and x-rays should know that the technicians at Cayuga Medical Center do limited studies on kids to reduce exposure, typically taking fewer views, as compared to adult patients. More views can be obtained only as needed.


What if I am pregnant and I need an imaging study?


Our position on pregnant patients is that we would generally prefer not to perform imaging studies of the abdomen or pelvis that utilize x-ray: we first recommend clinical diagnosis based on physical examination and Lab testing and, if imaging is still required, our preference is to start with ultrasound. However, when it is a potentially life-threatening situation, we are always available for consultation to help choose the proper imaging test and suggest ways to reduce exposure to the fetus.



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