The online version of this article (doi:10.1186/1476-7120-5-37) contains supplementary material, which is available to authorized users.
Eugenio Picano, Eliseo Vano, Richard Semelka and Dieter Regulla contributed equally to this work.
In April 2007, the American College of Radiology released the "White Paper on Radiation Dose in Medicine". The Blue Ribbon panel members included private practice and academic diagnostic radiologists, medical physicists, representatives of industry and regulatory groups, and a patient advocate. The panel concluded that the expanding use of imaging modalities using ionizing radiations such as CT and nuclear medicine may result in an increased incidence of radiation-related cancer in the exposed population in the not-too-distant future, and this problem can likely be minimized by preventing the inappropriate use of such imaging and by optimizing studies that are performed to obtain the best image quality with the lowest radiation dose. The White Paper set forth practical suggestions to minimize radiation risk, including education for all stakeholders in the principles of radiation safety and preferential use of alternative (non-ionizing) imaging techniques, such as MRI and ultrasound. These recommendations are especially relevant for cardiologists, who prescribe and/or practice medical imaging examinations accounting for at least 50% of the total effective dose by radiation medicine, which amounts to an equivalent of about 160 chest x-rays per head per year in US. Were they be enacted, these simple recommendations would determine a revolution in the contemporary way of teaching, learning and practising cardiology.
Mettler FA Jr: Report from National Council on Radiation protection. Diagnostic Imaging Online. April 16, 2007
Bedetti G, Botto N, Andreassi MG, Traino C, Vano E, Picano E: Cumulative patient effective dose in cardiology. BJR 2008.
European Commission: Radiation protection 118 : referral guidelines for imaging. Luxembourg: Office for Official Publications of the European Communities; 2001.
Thompson RC, Cullom SJ: Issues regarding radiation dosage of cardiac nuclear and radiography procedures. J Nucl Cardiology 2006, 13: 19-23. 10.1016/j.nuclcard.2005.11.004 CrossRef
Italian Health Ministry Medical Imaging Guidelines 2004: Linea guida Agenzia Servizi Sanitari Regionali e Istituto Superiore Sanità sulla diagnostica per immagini.[ http://www.sirm.org/professione/pdf_lineeguida/linee_diag_x_img.pdf]
World Health Organization, International Agency for Research on Cancer: Overall evaluations of carcinogenicity to humans, list of all agents evaluated to date.[ http://monographs.iarc.fr/ENG/Classification/Listagentsalphorder.pdf]
Agency for Toxic Substances and Disease Registry: Toxicological profile for ionizing radiation.[ http://www.atsdr.cdc.gov/toxprofiles/tp149.html#bookmark01]
US Department of Health and Human Services, Public Health Service, National Toxicology Program. Report on carcinogens. 11th ed[ http://ntp.niehs.nih.gov/index.cfm?objectid=32BA9724-F1F6-975E-7FCE50709CB4C932]
Committee to Assess Health Risks from Exposure to Low Levels of Ionizing Radiation; Nuclear and Radiation Studies Board, Division on Earth and Life Studies, National Research Council of the National Academies: Health Risks From Exposure to Low Levels of Ionizing Radiation : BEIR VII Phase 2. Washington, DC: The National Academies Press; 2006.
Bedetti G, Pizzi C, Gavaruzzi G, Lugaresi F, Cicognani A, Picano E: Sub-optimal awareness of radiological dose among patients undergoing cardiac stress scintigraphy. J Am Coll Radiol 2008.
Istituto Superiore di Sanità: Programma Nazionale Linee Guida. La partecipazione dei cittadini nelle scelte in Sanità. Ministero della Salute, Roma; 2005.
International Commission on Radiological Protection: Recommendations of the International Commission on Radiological Protection. In Draft Recommendations. Elsevier; in press. 25 May 2007
Andreassi MG, Cioppa A, Manfredi S, Palmieri C, Botto N, Picano E: Acute chromosomal DNA damage in human lymphocytes after radiation exposure in invasive cardiovascular procedures. Eur Heart J 2007, 30: 162-169.
Andreassi MG, Cioppa A, Botto N, Joksic G, Manfredi S, Federici C, Ostojic M, Rubino P, Picano E: Somatic DNA damage in interventional cardiologists : a case-control study. FASEB J 2005, 19: 998-9. PubMed
Venneri L, Salcone N, Botto N, Andreassi MG, Ahmed E, Lazzeri M, Gori C, Vano E, Picano E: Radiological exposure in contemporary interventional cardiologists. A part of the Intercardioreprostudy project. Eur Heart J 2007. (Abstract Suppl)
Picano E, Pasanisi E, Brown J, Marwick TH: A Gatekeeper for the Gatekeeper; Inappropriate Referrals to Stress Echocardiography. Am Heart J 2007, 154: 126-132. 10.1016/j.ahj.2007.04.032 CrossRef
International Commission on Radiological Protection: Recommendations of the International Commission on Radiological Protection. ICRP Publication 60 (Oxford : Pergamon Press); 1991.
International Commission on Radiological Protection: Radiological Protection and Safety in Medicine. ICRP Publication 73 (Oxford: Pergamon Press); 1996.
Rabin RC: With rise in radiation exposure, experts urge caution on tests. The New York Times;
Hirshfeld JW Jr, Balter S, Brinker JA, Kern MJ, Klein LW, Lindsay BD, Tommaso CL, Tracy CM, Wagner LK: ACCF/AHA/HRS/SCAI Clinical Competence Statement on Physician Knowledge to Optimize Patient Safety and Image Quality in Fluoroscopically Guided Invasive Cardiovascular Procedures : A Report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training. Circulation 2005, 111: 511-532. 10.1161/01.CIR.0000157946.29224.5D CrossRefPubMed
King BS, Aversano T, Ballard WL, Beekman RH, Cowley MJ, et al.: ACCF/AHA/SCAI 2007 Update of the Clinical Competence Statement on Cardiac Interventional Procedures : A Report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training (Writing Committee to Update the 1998 Clinical Competence Statement on Recommendations for the Assessment and Maintenance of Proficiency in Coronary Interventional Procedures). J Am Coll Cardiol 2007, 50: 82-108. 10.1016/j.jacc.2007.05.006 CrossRefPubMed
Mc Gaffighan E JrCommissioner US Nuclear Regulatory Commission at the Regulatory Information Conference Washington, D.C; [ http://www.nrc.gov/OPA]
- The American College of Radiology white paper on radiation dose in medicine:deep impact on the practice of cardiovascular imaging
- BioMed Central
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