Otha Linton is quite right that the benefits of medical imaging are well established and that we must not allow concern over radiation protection to provoke fear and scaremongering in the population. Such action would be poor medicine indeed.
Furthermore, Mr. Linton is right that that we must emphasize publicly that we are careful in using radiation—providing that we are sure we are.
However, there is a but, and it is a big one: we have no accurate scientific models to confirm whether current levels of population exposure from diagnostic radiology are harmful or not. There has never before been a time when so much medical exposure occurred, and science cannot tell us if this is safe; we are in uncharted territory here. The only way we will ever know whether those who claim that we are storing up a generation of radiation-induced disease are right will be in retrospect, when it will be too late to do anything about it. However, our professional response to this ought, surely, to be perfectly clear; if we cannot know, with absolute certainty, that we are practicing safely, then we are professionally obliged to be cautious. A lack of evidence and supposition of safety do not by themselves constitute defensible basis for practice.
The broad facts seem clear. The enormous increase in diagnostic imaging , computed tomography in particular, has virtually doubled the average exposure of the population. Unfortunately, that average translates as a much higher exposure of a selected population. We know that it is not difficult for a patient to undergo 10 or more computed tomographic scans in a single disease episode in a single year . Even more, we know that there are variations of an order of magnitude in the exposure used for the same application between different centers ; this latter in particular is very difficult to defend as careful.
Better, though, to be practical than panic stricken. In my opinion, cautious practice requires us all to:
ensure that radiation, computed tomography especially, is used only when absolutely justified;
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References
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