Harnessing the power of radiation SAFELY
People are worried about radiation. They’ve read reports of radiation trickling in with ocean currents from Japan; wondered about the impact of airport security systems; heard about potential exposure from utility “smart meters” and their cell phones; and considered the safety of imaging procedures at medical offices.
When it comes to the medical use of radiation, people should be cautious, say the experts at Community Hospital. They should ask questions about procedures and equipment, and about physician and staff training, certification, and experience.
Used appropriately, by trained personnel, radiation is a critical healthcare tool. It is used for diagnosis, through imaging procedures; and used for treatment, such as targeting cancerous cells, through radiotherapy.
Dr. Patrick Feehan
“To the cancer patient, for example, radiation is a friend,” says Dr. Patrick Feehan, a board-certified radiation oncologist at Community Hospital. “Radiation is the single most lethal way of killing cancer cells.”
Feehan, chair of the Radiation Safety Committee at Community Hospital, encourages people to ask certain questions before receiving radiation treatment, wherever they are considering having it:
- Is the center certified by the American College of Surgeons?
- If you are being treated at a Comprehensive Cancer Center, has it received the Outstanding Achievement Award, the highest honor from the American College of Surgeons?
- Does the center have a full-time physicist to review treatment plans, provide quality control of equipment, consult on radiation dosage, and help ensure that radiation safety measures are followed?
- Does the center have full-time dosimetrists — trained, certified staff members who calculate safe and effective radiation doses?
- Are radiation output levels checked regularly?
- Is a radiation oncologist present for every treatment?
- Is the radiation oncologist readily available if there are any unexpected side effects?
“I know that at Community Hospital,” Feehan says, “our answer to all these questions is ‘Yes.’ We have a full-time physicist and the best equipment available. We check the output of our radiation machines on a daily basis. We have very tight standards; we work very hard to administer exact radiation dosages.”
Dr. Anthony Filly
Dr. Anthony Filly, a board-certified radiologist at Community Hospital, suggests similar questions for patients undergoing a procedure or exam using radiation, such as a CT scan. His suggested questions:
- Is the department or center certified by the American College of Radiology (ACR)?
- Does it participate in the ACR’s National Dose Registry Project, which compares data regionally and nationally to improve the quality of patient care?
- How do its doses compare to the doses at other hospitals and centers?
- Has it joined the ACR’s Image Gently™ and Image Wisely campaigns, which raise awareness of opportunities to eliminate unnecessary imaging examinations and to lower radiation in necessary imaging examinations to the minimum needed to acquire appropriate images?
- Once a scan has been scheduled, is a radiologist available to answer questions about dose?
- Does the department or center use bismuth shields to protect the breasts and thyroid from radiation?
- Are the CT scanners equipped with current dose-reduction functions?
- What actions has the center taken to reduce radiation dose from CT scans and X-rays?
At Community Hospital, Filly began an initiative more than five years ago to adjust CT scan protocols to use the lowest dose of radiation possible and still get a clear image. Then he determined the median dose range and compared it to studies from other area hospitals. This small study revealed that Community Hospital is well below the median doses administered at other area institutions.
“We also know that our median dose is at or below even the lowest doses seen in national studies,” he says.
“When we have compared our doses to other institutions in the immediate area on a patient-by-patient basis, Community Hospital has also shown to be significantly lower,” Filly says.
“Through this initiative and the CT technology available at Community Hospital,” he continues, “we have been able to adjust the radiation dose on every single image for every patient, and use just enough to get a clear picture.
“At this time, radiation is the best test for many issues; there’s no way around it. So if you have to have it, it’s best to get the lowest dose possible.”
Comparing Radiation Exposures
Community Hospital is committed to using the lowest possible dose of radiation to acquire clear images. Community Hospital’s median radiation doses in a range of computed tomography (CT) scans of adults were equal to or lower than the median of Bay Area hospitals studied by UC San Francisco. (Figures are in millisieverts, a commonly used radiation measurement.)
||Community Hospital median dose
||Bay Area hospitals' median dose
||Difference at Community Hospital
|CT chest scan
||38 percent lower
|CT head scan
||38 percent lower
|CT pulmonary embolism angiography
||40 percent lower
|CT coronary angiography
||77 percent lower
All people are exposed to radiation daily from natural and manmade sources, including materials in the soil and cosmic rays from outer space. Some common ways that people are exposed to radiation with their associated doses are shown below.
|Cosmic rays during roundtrip flight from Los Angeles to New York
|Full-body airport screening
||.25 (maximum limit)
|One year of natural radiation
*Represents the average annual exposure in the U.S. Exposure is greater at higher elevations than at sea level, doubling every 6,000 feet. So someone who lives at sea level receives about one-half the dose from cosmic radiation as that received by a resident of Denver, Colo., the “mile-high” city.
Information Sources: Anthony Filly, MD, radiologist, Community Hospital; UC San Francisco; U.S. Department of Health and Human Services; and Washington State Department of Health