American Family Children's Hospital

UW Health Strengthens Diagnostic Imaging Protocols, Reduces Radiation Exposure

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Each year, 70 million computed tomography (CT) scans are performed in the United States, which can result in more accurate diagnosis and appropriate treatment leading to better health outcomes. Because ionizing radiation kills cells – even healthy ones – radiation overexposure can be harmful. Although the exact risks of repeated exposure to ionizing radiation from medical imaging remain unclear, the UW Department of Radiology has made radiation exposure awareness a top priority.


Committed to Maintaining the Highest Standards of Patient Safety


At UW Health, robust safety measures are in place to reduce or eliminate patient exposure to ionizing radiation during medical imaging. When appropriate, a test that does not use ionizing radiation – such as magnetic resonance imaging (MRI) or ultrasound – will be performed as an alternative. However, "the benefits of CT examinations usually far outweigh the potential risks of radiation," says Jeffrey Kanne, MD, associate professor of Thoracic Radiology and vice chair of Quality and Safety at UW School of Medicine and Public Health.


“To ensure patients are not exposed to radiation unnecessarily, the UW Department of Radiology and Department of Medical Physics have designed CT scan protocols that provide images of the highest quality while delivering the optimal radiation dose to the patient, taking advantage of current image enhancement technologies and radiation dose reduction techniques,” says Dr. Kanne.

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Smallest and Youngest Patients are Most Vulnerable to Radiation


Following appropriate protocols helps ensure patient safety. Bradley Maxfield, MD, chief of Pediatric Radiology at American Family Children's Hospital, says, "We look at all the requests for CT scans to ensure that only the appropriate tests are ordered. We don't want to do tests that we don't have to do. We want to make sure we do the right test first. It's also important to avoid redundant scans, overlap any areas of the body and scan any areas of the body more than necessary," says Dr. Maxfield.


Superfluous exposure to ionizing radiation may be dangerous to patients. Dr. Maxfield says, "One size definitely does not fit all." He explains, "The smallest and youngest among us are most sensitive to radiation overall. It is extremely important to use protocols that are based on age and body size in order to determine the technical factors of the CT scan."


According to Dr. Kanne, "UW Health’s pediatric CT protocols exceed the American College of Radiology's (ACR) guidelines, providing superior image quality while reducing pediatric patient dose as much as appropriate."


Limiting patient exposure to ionizing radiation is more complex than just turning down the radiation dose. This may produce an image that is not of diagnostic quality. Dr. Maxfield says, "If you turn it down so low that you cannot get any good information, then you have exposed the patient to radiation and you don't have anything valuable from it."


Iterative Reconstruction Enables More Precise Images with Significantly Less Radiation


In addition to UW's refined CT protocols, there are also many exciting technical developments in the field of CT that help reduce patient radiation exposure. UW School of Medicine and Public Health's Departments of Radiology and Medical Physics are developing iterative reconstruction techniques, which provide similar image quality using less radiation.


According to Dr. Maxfield, "We can further reduce the dose with iterative reconstruction by a third and even up to a half of the amount of radiation that it would have taken for a diagnostic image 5 to 10 years ago. The combination of research by clinical radiologists working closely with medical physicists quickly takes abstract scientific ideas and translates them into practical applications in clinical radiology in a much shorter period of time."


New Low-Dose Capabilities for Select Nuclear Medicine Exams


Nuclear Medicine is reducing patient exposure from radiopharmaceuticals by approximately 50 percent for a common exam, cardiac single photon emission computerized tomography (SPECT). They use refined reconstruction techniques to obtain the same high quality images with half the radiation dose. Nuclear Medicine at UW Health uses hybrid nuclear medicine/CT cameras for cardiac imaging. These cameras have the lowest CT exposure available today.


The UW Department of Radiology practices ongoing quality improvement, and radiation dose monitoring and reduction continue to be a core quality practice.


"We surpass standards issued by the ACR with respect to image acquisition and reporting. We remain committed to the needs of our referring physicians as well as to the needs and safety of our patients," says Dr. Kanne.


UW radiologists are available for consultation if there remain any questions about whether a CT scan should be performed. For more information, to find answers to your questions, or to contact a member of the UW Health Radiology faculty at the numbers below:


  • Abdominal imaging: (608) 265-7216
  • Breast imaging: (608) 262-7133
  • Thoracic imaging: (608) 265-7250
  • Cardiovascular imaging: (608) 263-1229
  • Musculoskeletal imaging: (608) 263-6461
  • Neuroradiology: (608) 263-8623
  • Nuclear medicine: (608) 263-9308
  • Pediatric imaging: (608) 263-0670
  • Vascular interventional radiology: (608) 263-8326