Help wanted: Radiation protection requires out-of-the-box thinking

The 21st century challenges of radiation protection requires all stakeholders to collectively think outside of the box to communicate with patients and develop tools to address the challenges of radiation exposure, according to a medical physics and informatics review published in the April issue of American Journal of Roentgenology.

As radiation doses have increased and concerns have escalated, key players have failed to present a unified front to patients. “Unfortunately, professionals are speaking with different voices that leave patients confused,” wrote Madan M. Rehani, PhD, from the International Atomic Energy Agency in Vienna.

The need to communicate with a common voice outweighs the need to claim personal positions as the correct one, he continued.

Rehani outlined “an ideal world” of radiation protection and how different stakeholders can play a part in developing solutions.

• Radiologists can support an electronic referral system that ensures appropriateness for every imaging exam and includes radiation dose and prior images. They also could champion an integrated grading system for radiologist practice quality.
• Technologists could improve performance if provided alert messages when image quality (and radiation exposure) exceeds what’s required for diagnostic quality.
• Referring physicians can lobby for access to previous imaging studies, decision support and alerts and checks to warn of inappropriate referrals.   
• Dosimetrists can work to eliminate multiple units of radiation dose measurements and work toward a common unit scheme, such as Celsius for temperature or kilometer for distance.
• Radiation biologists can focus on the development of a biologic indicator of radiation exposure for organ doses, similar to the hemoglobin A1c test.
• Patients can benefit from accessible radiation exposure performance indicators for imaging facilities and a dose smart card that includes personal exposure history.
• Vendors can continue the radiation reduction arms race to achieve the ultimate goal of sub-mSv exams for any part of the body.