
A handful of recent warnings about radiation exposure during medical imaging has device makers eager to distance themselves from the potential cancer risk.
Catalyzed by a study finding in recent years a "boom" in the use of medical imaging, the Medical Imaging & Technology Alliance issued a rejoinder arguing that use has begun to decline and that device makers are actively innovating systems that lower the radiation dose.
"The use of diagnostic imaging in the Medicare population has increased significantly over the last 2 decades, particularly using expensive new technologies such as computed tomography, magnetic resonance imaging, and nuclear medicine positron emission tomography," according to the study published in the June issue of the Journal of the American Medical Assn, which gathered data from 6 large integrated health systems from different regions of the U.S.
Imaging costs are "high and rapidly growing" in the U.S., researchers wrote, and "payments to physicians for diagnostic imaging have had the highest rate of growth among all physician services over the last decade."
Although the study attributes diagnostic imaging to earlier and more accurate disease diagnosis, researchers also warned that "it is estimated that 2% of future cancers will result from current imaging use, if imaging continues at current rates."
Between 1996 and 2010 use of CT imaging increased 7.8% per year, MRI increased 10% per year and ultrasound increased 3.9% per year, according to the data. Nuclear medicine use decreased 3% yearly, but PET scanning increased about 57% year-over-year.
"Increased use of CT between 1996 and 2010 resulted in increased radiation exposure for enrollees, with a doubling in the mean per capita effective dose and the proportion of enrollees who received high exposure and very high annual radiation exposure," according to the study.
The average patient received 1.18 tests annually, and "by 2010 6.8% of enrollees who underwent imaging received high annual radiation exposure and 3.9% received very high annual exposure," researchers concluded.
The study comes among growing concern about possible cancer risks associated with diagnostic imaging and an FDA push for imaging devices with specific protocols designed to minimize radiation exposure in pediatric patients.
UC radiology and biomedical imaging professor Rebecca Smith-Bindman, lead author on the JAMA study, penned a companion article warning that women may faced increased risk of breast cancer from excess breast cancer diagnostic tests.
Referring to an Institute of Medicine report, published in December, Smith-Bindman wrote that "the single thing that the IOM highlighted that a woman can do to lower her risk of breast cancer is to avoid unnecessary medical imaging."
Earlier this month a research team from Newcastle University warned that children receiving frequent CT scans may be exposed to radiation that slightly increases their risk of developing brain cancer or leukemia.
The JAMA report noted that the testing boom had "flattened or minimally declined in more recent years" for most scanning types, although PET imaging use continued to increase through 2010.
"The data gathered by Dr. Smith-Bindman and colleagues suggest that usage of advanced imaging modalities such as computed tomography is now declining, a fact which has been corroborated by several recent independent analyses of Medicare and private insurance data, including by the Medicare Payment Advisory Commission," according to a MITA press release. "As a result of this trend, patients are actually receiving fewer imaging procedures, which further debunks the myth that life-saving diagnostic imaging services are growing and contributing to rising health care costs."
MITA cited a handful of studies finding that diagnostic imaging had contributed to declines in cancer deaths, and noted that the American Society of Clinical Oncology n 2011 named CT-based lung-cancer screening among the top 5 advances in the fight against cancer.
"In the 1990s and early 2000s, manufacturers introduced innovative technologies that enabled physicians to diagnose, monitor and treat cancers and other diseases more safely, quickly and efficiently using scans than by conducting invasive surgeries or admitting patients to the hospital without reason," MITA wrote in a statement sent to MassDevice.com. "Today, MITA members continue to forge ahead with new breakthrough products, system innovations and patient care initiatives that optimize radiation dose for many procedures while providing cutting-edge medical care that saves lives and reduces long-term costs."
The industry group also sponsors initiatives such as the "Image Wisely," "Image Gently" and "Choosing Wisely" campaigns for reducing unnecessary radiation exposure in adults and children.
"Medical imaging and radiation therapy are increasingly integral to medical care, and their use reduces hospital stays and helps return patients to their families, lives, and work more quickly," MITA executive director Gail Rodriquez said in prepared remarks. "Imaging and radiation therapy manufacturers will continue to lead efforts to reduce unnecessary radiation exposure while maintaining or even improving patient care from computed tomography, fluoroscopic and diagnostic x-ray studies, nuclear medicine tests, and therapy treatments."