Modern Medical Imaging: The Silent Divorce from ALARA

            
             Utilization of medical imaging continues to rise. This is true of the pediatric population as well as adults. With increased exposure there is a correlating risk of radiation induced cancers, particularly leukemia. The purpose of this project is to examine current imaging technology and practice to determine if doses can effectively be reduced and still maintain diagnostic image quality. The hypothesis is that current digital media will be able to account for variances that might degrade image quality and still yield a diagnostic study. Alternatively, radiation protection techniques may demonstrate an impact on image quality that could be corrected for through training and procedural optimization. The results were that one hundred percent of the randomly audited imaging studies were categorized as of diagnostic quality in spite of poor adherence to radiation protection standards. .
             Introduction.
             From the beginning, the practice of medicine, in all its disciplines has been about improving the lives of patients. This focus becomes ever more important as the populations increase in number and age. Utilization of medical services increases annually. The United States alone spent 2.6 trillion dollars on healthcare in 2010. (US Healthcare Costs) From a diagnostic imaging perspective, approximately 3.6 billion x-rays were performed worldwide. (UN News, 2010) Seventy-one million chest x-rays are performed in the U.S. annually. (Gilkeson and Sachs, 2004) The United Kingdom has seen a five percent increase in utilization of medical imaging annually since 1974. (Lowe et al, 1999) With evidence of such numbers historically, and the prediction that utilization of medical imaging will continue to increase, it becomes increasingly important to pay attention to patient safety in the radiologic domain.
             Research Question.
             Is there a correlation between dose reduction techniques and image quality with current digital technology? What impact does that have on patient safety in medical imaging? These questions are of particular relevance in urging practitioners to follow ethical guidelines regarding the safe, responsible use of ionizing radiation.