A leading researcher from the University of California-San Francisco has spent years studying the risks of radiation from CT scans, which are commonly used in modern medicine. Rebecca Smith-Bindman, a professor at UCSF, has highlighted concerns that these scans, while essential for diagnosing life-threatening conditions, can increase the risk of cancer due to high radiation doses.
Smith-Bindman and other experts have been advocating for changes in federal policies to make CT scans safer for patients. This year, new regulations from Medicare require hospitals and imaging centers to collect and share more data on the radiation emitted by their CT machines.
In the United States, around 93 million CT scans are performed annually, with more than half of them involving patients over the age of 60. However, there is limited regulation on the radiation levels used during scans, leading to significant variations in dosages across different clinics. Experts, including Smith-Bindman, warn that these doses are often unnecessarily high.
“It’s unfathomable,” said Smith-Bindman. “We keep doing more and more CTs, and the doses keep going up.”
CT scans can expose patients to radiation levels that vary widely. In some cases, a single scan can involve radiation doses that are 10 to 15 times higher than another for the same medical issue. Research shows that this variation can be even more extreme in certain hospitals.
In 2009, Smith-Bindman and her team estimated that excessive radiation from CT scans could be responsible for 2% of cancer cases. Since then, the number of CT scans performed each year has only increased, likely making the cancer risk higher.
While the risk of developing cancer from a single CT scan is low, the risk increases for patients who undergo multiple scans throughout their lives. Radiologists stress that CT scans are essential for diagnosing serious health conditions such as cancer and aneurysms. However, the goal is to ensure that patients benefit from these scans without unnecessary radiation exposure.
The new regulations from the Centers for Medicare & Medicaid Services (CMS), which began rolling out in January, aim to improve patient safety. The rules focus on measuring and reducing unnecessary radiation exposure. Over the next few years, hospitals and physicians will be required to follow more rigorous protocols for CT scan radiation levels, with penalties for non-compliance starting in 2027.
A CMS spokesperson emphasized that unnecessary radiation exposure is a health risk that can be addressed through better data collection and feedback to healthcare providers. The guidelines were developed in collaboration with UCSF, which has been researching methods to improve CT scan safety.
Leah Binder, president of the Leapfrog Group, a patient safety organization, praised the new rules. “Radiation exposure is a very serious patient safety issue, so we commend CMS for focusing on CT scans,” she said.
However, some groups in the medical imaging field, including the American College of Radiology, expressed concerns during the draft phase of the regulations. They worried that the new rules would be burdensome for providers and could increase the cost of scans. Some critics also raised concerns about the use of a single software tool, provided by Alara Imaging, to track data.
Despite these objections, the CMS regulations aim to encourage safer imaging practices. Health organizations, including the Institute of Healthcare Improvement, have supported the push for better data collection and quality control in CT scans.
Concerns about CT scan radiation have been around for years. A study published in JAMA Internal Medicine in 2009 estimated that CT scans were responsible for 29,000 excess cancer cases annually in the U.S. Since then, the number of scans has continued to rise, though radiation per scan has decreased in some cases.
Some studies, including those involving pediatric patients and survivors of the Hiroshima and Nagasaki atomic bombings, show that radiation from CT scans can be especially harmful to younger individuals.
Experts also note that older patients who received scans earlier in life may be at increased risk. Max Wintermark, a neuroradiologist at MD Anderson Cancer Center, said that advancements in technology, including artificial intelligence, could help doctors reduce radiation doses by determining the minimum amount needed for diagnosis.
“I think the measures will help accelerate the transition towards always lower and lower doses,” Wintermark said. “They are helpful.”
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