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Physicians, researchers, physicists, engineers and other creative and clinical partners have worked together over the years to continually develop and introduce evolution-ary medical imaging equipment. On a regular basis, the medical imaging community announces faster and more accurate features, methods to improve image quality or lower patient exposure, new applications for imaging equipment and new technologies and modalities. Health care patients benefit from the dedication of budgets and brilliant minds; use of medical imaging can speed and improve diagnosis of a myriad of diseases. Over the past few decades, use of many medical imaging modalities has grown exponentially. For example, 26 million computed tomography (CT) examinations were conducted in the United States in 1998; by 2008, more than 70 million CT examinations were conduct-ed. During the same 10 years, nuclear medicine studies increased from 12 million to nearly 20 million. The tremendous growth in medical imaging has improved patient care in the United States and around the world. However, some risks and drawbacks have accompanied that growth. Appropriate use and associated costs are of concern to payers and policymakers. Most notably, increased use of diagnostic studies involving ionizing radiation can add to patients’ cumulative exposure. Medical imaging contributes to about 15 percent of the average effective dose per capita of people in the United States, and background radiation accounts for 83 percent. In particular, CT and nuclear medicine have been the focus of concerted efforts to estimate and reduce patient exposure. Use of these imaging modalities has increased and certain CT and nuclear medicine examinations introduce higher doses of radiation than do conventional radiography examinations. Estimates show that CT accounts for about 49 percent of patient exposure to ionizing radiation from medical imaging, and nuclear medicine examinations account for 26 per-cent of patient exposure.4
The number of radiographic and fluoroscopic studies skyrocketed from 25 million in 1950 to 293 million in 2006.5 Fluoroscopy is used in a range of diagnostic and therapeutic imaging procedures, and has been the focus of improved technique and monitoring in recent years because of the potential for high skin dose and radiation effects. As medical imaging departments transition from an analog to digital environment, there has been a potential for increased patient exposure as radiologic technologists adjust to digital imaging technology.8 The American Society of Radiologic Technologists (ASRT), American College of Radiology (ACR) and other organizations continue to address this issue in white papers and with educational campaigns, and the vendor community has supported efforts with education and equipment standardization.
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