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Too Much Radiation From Medical Imaging?

Researchers Say Patients Need to Weigh Risks vs. Benefits of Imaging Tests
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Value of Some Medical Imaging Unclear

In a perspective published with the study, cardiologist Michael S. Lauer, MD, of the National Heart Lung and Blood Institute (NHLBI) presented the hypothetical case of a 58-year-old man named Jim with risk factors for heart disease who has an inconclusive nuclear stress test followed by another commonly used imaging test known as CT angiography, which also fails to confirm his diagnosis.

The two tests would result in more than 20 mSv of radiation exposure.

"Jim's story reflects outpatient practice that has become increasingly common in the United States, which has the world's highest per capita imaging rate," Lauer writes.

"Most physicians who order imaging tests experience no consequences for incurring costs for procedures of unproven value. On the contrary, they or their colleagues are paid for their services, and their patients don't complain because the costs are covered."

While health care reform has the potential to slow the growth of medical imaging, Lauer says the real challenge is to identify which tests add value for the diagnosis and management of disease and which do not.

He tells WebMD that for some tests, like mammography, the benefits are clear. But for others, like nuclear stress testing to identify heart disease, the risks may very well outweigh the benefits.

"Medical practice should be based on the most rigorous science, and we don't have that for many of these tests," he says. "We need large, well-designed trials to figure this out."

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