Introduction
Ionizing radiation has been used for diagnostic purposes in medicine for more than a century. The benefits are immense and certainly exceed the risks. The more recent development of remarkable equipment such as multidetector row computed tomography and the increased utilization of x-ray and nuclear medicine imaging studies have improved the lives of our patients and, along with other new modalities, revolutionized the practice of medicine. However, this dramatic evolution of imaging has also resulted in a significant increase in the population’s cumulative exposure to ionizing radiation. Will this cause an increased incidence of cancer years down the line? Although the answer to that question is currently under debate, the presumption is that it will.
Consequently, there is increasing international and federal interest in, and scrutiny of, radiation dose from imaging procedures. Although there has been recent widespread interest in patient safety issues [1], the possible hazards associated with radiation exposure generally have not been brought into clear focus by the public or members of the medical community other than radiologists. The ACR, pursuing its commitment to radiation safety, currently supports the following activities: accreditation programs, practice guidelines and technical standards [2], Appropriateness Criteria® [3], a dose index registry (in progress), educational programs, the RadiologyInfo public information Web site (jointly developed with the Radiological Society of North America [RSNA]) [4], collaborations with government and legislators on safety issues, and research activities such as the ACR Imaging Network (ACRIN)®. To further enhance radiology’s leadership role in the arena of patient safety, the chairman of the ACR Board of Chancellors convened the ACR Blue Ribbon Panel on Radiation Dose in Medicine to assess the current situation and to develop an action plan for the ACR that would further protect patients and inform the public. Panel members included private practice and academic diagnostic radiologists, medical physicists, representatives of industry and regulatory groups, and a patient advocate. This white paper is the result of the panel’s deliberations.