CT scans can be better medicine for doctors than for patients
They provide detailed views of internal organs, but the price is increased doses of radiation.
By Alan Zarembo, Los Angeles Times Staff Writer
September 7, 2008
When Maureen Scanlan had a painful kidney stone episode four years ago, she was pleased that her doctor ordered an
annual regimen of CT scans to monitor her condition.
The scans involved hundreds of razor-thin X-rays of her innards stitched together by a computer into stunningly detailed
3-D images showing the size and location of the stone, down to the millimeter.
Anatomy of a CT scan
(click the link or read the diagram and table after the article)
What she didn't realize was that the perfection of the images was a result of a radiation dose equivalent to more than a
dozen standard abdominal X-rays -- all for a condition that though painful is relatively mundane.
"I never thought twice about it," said the 38-year-old mother of two from Westfield, N.J., who since learning of the radiation
has been worried that the scans may have played a role in two miscarriages. "I knew there was radiation, but I didn't
realize how strong it was."
Scanlan is part of an explosion in the use of one of the most revolutionary medical
technologies of the last half century.
Introduced in the 1970s, computed tomography scans have become a standard procedure for such common problems as
kidney stones, persistent headaches and appendicitis.
Doctors in the U.S. ordered 68.7 million CT scans last year, more
than triple the number in 1995, according to IMV Medical Information Division, a medical market research group in Des
Generating tens of billions of dollars in billing each year, CT scanning has become an economic engine for
hospitals and doctors, and the once-exotic million-dollar devices are starting to be found in private practices.
into the culture of doctors," said Geoffrey Rubin, a Stanford University radiologist.
But with the boom has come a rising concern that the abundant use of radiation is beginning to have a subtle effect on the
health of the nation.
Although the risk of a single CT scan to an individual is minuscule, even a tiny increase in radiation
exposure spread over a large population can eventually add up to tens of thousands of cancer deaths a year.
controversial study published last November in the New England Journal of Medicine estimated that CT scans
administered today could cause up to 2% of cancer deaths in two or three decades.
The doctors who have embraced the
technology in increasing numbers say the small increased risk is a minor price for a snapshot of the body so detailed it
can delineate hidden infections of the sinuses, tiny blood clots in the lungs and thin layers of plaque on heart vessels.