This week, an editorial in the New England Journal of Medicine is highlighting the growing concern over CT scans. These scans give doctors an extremely sharp x-ray picture which allows them to quickly rule in or out many types of injury or disease. However, now experts are saying that Congress should give the FDA oversight on the use of CT scans due to the concern over the risks of increased exposure to radiation.
A combination of patients asking for tests they might not need and doctor's reliance on the scans has increased the use of the scans and therefore American's exposure to radiation. According to the Associated Press, 10 percent of the U.S. population gets a CT scan, and use of this imaging is growing more than 10 percent per year. "That's really the area we should focus on," said the author of one of the Journal articles, Dr. Rebecca Smith-Bindman. She is a radiologist at the University of California at San Francisco on temporary leave to do radiation research at the National Cancer Institute.
Not only is Smith-Bindman concerned with the increase in exposure to radiation experienced by the public in general, but the accidental overdoses of intense radiation to individuals, as well. The editorial in the New England Journal concerned one patient who received an radiation overdose from the brain-perfusion scans given to her. According to the report by USA Today, after the patient complained of hair loss and confusion, the doctors realized she had received 10 times the normal dose of radiation. Smith-Bindman says in that case, doctors could have ordered a routine head CT that exposes patients to one-tenth as much radiation as normally found in the brain-perfusion scans.
To help the public at large, Congress should set clear standards by giving the FDA authority to regulate how CT scans are used, Smith-Bindman says. She points to a 1992 law regulating mammograms, for example. According to Smith-Bindman, this law has reduced radiation exposure and helped women everywhere get the same high-quality care.
One foreseeable problem with the regulation by the FDA over CT scans though, is the scope. Dr. David Brenner of Columbia University Medical Center points out to USA Today that mammograms are used for a single purpose. CT scans have dozens of uses, covering everything from detecting cancer to examining the heart. This will make it far harder for the FDA to develop useful and effective guidelines that will not interfere with the Doctor's decisions regarding the wide variety of uses for the CT scan.