Dr. Andrea Yeung discusses the measures we take to minimize the radiation patients are exposed to during a CT scan in our office.
Balloon Sinuplasty™ technology
Balloon Sinuplasty™ technology is a FDA-cleared, endoscopic, catheter-based system for patients suffering from sinusitis. The technology uses a small, flexible, Sinus Balloon Catheter to open up blocked sinus passageways, restoring normal sinus drainage and function. When the sinus balloon is inflated, it gently restructures and widens the walls of the passageway while maintaining the integrity of the sinus lining.
Presentations
Atul Gawande's Speech - The Checklist Manifesto: How To Get Things Right
Check Dr. Atul Gawande's full speech on “The Checklist Manifesto: How To Get Things Right”. This speech was given on January 13, 2010 at UCSF Medical Grand Rounds. Dr. Gawande highlights the important role that a simple checklist can play in ensuring consistent, reliable, and high quality patient care.
San Francisco Thyroid brings diagnotic and treatment together
When a group of Brown & Toland physicians started the Thyroid Center of San Francisco in October, their goal was to make the clinic a convenient one-stop shop for patients seeking coordinated care for thyroid cancer. Today, the clinic houses all the services needed to help identify and treat thyroid cancers: endocrinology, imaging, aspiration, pathology and surgery. “Our clinic is the hub where all that comes together,” said Jacob Johnson, M.D., one of the clinic’s partners. Patients can head to one central location to receive care, often with a quick turnaround. As a side benefit, patients can build a relationship with a small cadre of healthcare providers who work in concert with their primary care doctors.
The following information is adapted from a presentation given by Dr. Kirk Moon, head of Radiology at California Pacific Medical Center, San Francisco, CA on May 2, 2010. Download complete presentation here.
The concern about increasing radiation doses from medical imaging has been building for years due to the dramatically expanded use of medical imaging over the past 20 years. CT usage has increased approximately 10% every year for the past 10 years.
Potential Risks
Heritable genetic mutations in germ cells
Effect not seen at doses employed in medical imaging
In utero damage to fetus
Important risk, but special circumstance and not subject of this presentation
Acute radiation sickness
Only seen at very high doses and in exceptional circumstances. Not discussed in this presentation.
Cancer induction
The most important effect and the focus of this presentation
Summary of cancer risk
Females are approximately 50-80% more radiosensitive than males across all ages
Radiosensitivity decreases continually with age – young children are particularly radiosensitive
Newborns are 3-5x more radiosensitive than 30 year olds
30 year olds are twice as radiosensitive as 70 year olds
Different organs have different degrees of radiosensitivity
Brain < neck < chest/abd/pelvis
Tissues with rapid cell turnover more radiosensitive than others
“Bottom Line”
Doses associated with most imaging procedures are quite modest and pose little additional risk
A limited number of procedures carry substantially higher doses than average and have a measurable added risk, even for a single procedure
The biggest risk isn’t from single procedures but from cumulative dose
Estimated Radiation Doses
The Mean annual effective dose absorbed as “background radiation” is 3.11 mSv. LAR is the “Lifetime Associated Risk” increase of getting cancer from this dose of radiation.
Doses listed are estimates for a standard CT scanner. The unit sievert (Sv) specifically measures absorbed radiation which is absorbed by a person; the units listed here are millisieverts (mSv), or 0.001Sv
Radiation workers (including radiologists) are permitted to receive a whole body exposure of 50 mSv per year.
Typical radiotherapy fraction = 1800-2000mSv
Smoking cigarettes more than doubles risk of AMI (>200% added risk)
What You Can Do
Ask Questions. Understand why you are having the test and ask your doctor about the radiation dose associated with it.
Log your lifetime radiation exposure. This will help you and your doctor make an informed decision about the risk-benefit ratio of getting a particular test. Download radiation log here
Look for low-dose alternatives. The Xoran MiniCat is one such example, with 10-50x less radiation than a traditional CT scanner. This new technology is an especially safe option for children. Click to visit minicat page on our site
