In a study of records from 1996 through 2010 from six large U.S. health systems, it was found that the use of CT scans increased 7.8% per year, from 52 per 1,000 members in 1996 to 149 per 1,000 members in 2010. MRIs increased by 10% per year, from 17 per 1,000 members in 1996 to 65 per 1,000 members in 2010. Ultrasound imaging increased by 3.9% per year, from 134 per 1,000 members in 1996 to 230 per 1,000 members in 2010. PET imaging rates were low but increased rapidly after 2004, from 0.24 per 1,000 members to 3.6 per 1,000 members. However, nuclear medicine declined 3% per year, from 32 per 1,000 members in 1996 to 21 per 1,000 members in 2010.
As a result of the increased use of imaging tests in the U.S., it is estimated that radiation exposure almost doubled from 1.2 mSv per capita to 2.3 mSv per capita from 1996 to 2010.
It is estimated that 30% or more of all advanced imaging tests, which are done at an estimated cost of $100 billion per year, are unnecessary. While advanced imaging tests no doubt have benefited many patients who have undergone such testing, the tests do come with risks such as an increased risk of cancer over one’s lifetime. For those who received advanced imaging tests in 2010, 6.8% received a “high” level of radiation exposure and 3.9% received a “very high” level of radiation exposure.
Patients receiving greater than 50 mSv of radiation exposure (which exceeds the maximun occupational radiation exposure level allowable in the United States) rose from 0.6% in 1996 to 1.4% in 2010. Patients receiving between 20 mSv and 50 mSv of radiation exposure (the equivalent of between 2 and 5 CT scans) rose from 1.2% in 1996 to 2.5% in 2010.
The reasons for the increasing use of advanced imaging tests may include expanding indications for such tests, the greater availability of the tests, demand for the tests from both patients and their physicians, and possibly health care providers practicing defensive medicine by ordering such tests.
The study’s results suggest that medical practitioners who order advanced imaging tests involving ionizing radiation should consider each patient’s cumulative radiation exposure and discuss the benefits and risks with patients when deciding whether to order such tests. However, the study’s researchers warn about the limitations of their study and the need for more data.
Most patients have no idea how much radiation they may be exposed to during medical testing ordered by their health care providers. It is time for patients to educate themselves and become active participants in their own health care by questioning their doctors as to the need for the tests and the known risks and benefits of the testing. If your health care provider is unable or unwilling to discuss your questions or unable to answer your questions to your satisfaction, it may be time to seek a second opinion (if time permits) regarding the necessity of the tests and the risks associated with the tests.
If you or a loved one have been injured as a result of medical testing, imaging studies, or as a result of other medical negligence, you should promptly consult with a local medical malpractice attorney regarding your possible medical malpractice claim.
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