Statement on Enhancing Radiation Safety in CV Imaging

The American Heart Association (AHA) has released a scientific statement outlining practical and specific strategies on enhancing radiation safety in cardiovascular imaging. The statement was published Sept. 29 in Circulation, and is endorsed by the ACC, American Society of Nuclear Cardiology, North American Society for Cardiovascular Imaging, Society of Cardiovascular Computed Tomography, and Society for Coronary Angiography and Interventions.

For years radiation imaging has served as an invaluable tool in the diagnosis and management of numerous conditions. However, as a consequence of the technology’s widespread availability and capabilities, the use of medical imaging has increased significantly in the U.S., with nearly 40 percent of this rising medical radiation exposure falling on its related use in cardiovascular imaging and intervention, according to the statement.

Targeting clinicians who refer patients for cardiovascular imaging procedures, as well as those who perform the procedures, the newly published scientific statement is divided into three key approaches: education, ensuring that patients and clinicians understand the potential benefits and risk of medical imaging studies; justification, that an imaging procedure is deemed clinically justified and appropriate; and optimization, that radiation exposure from imaging kept as low as reasonably achievable.

The statement’s authors argue that education regarding the benefits and risks of imaging and the principles of radiation safety is required for all clinicians in order for them to be able to use imaging optimally and that empowering patients with knowledge will facilitate a meaningful participation in decisions related to their own health care. Meanwhile, limiting the use of imaging to appropriate clinical indications can ensure that the benefits of imaging far outweigh any potential risks. Even when a cardiac imaging study is appropriate, if a comparable test that does not use radiation is able to provide the clinical information needed with comparable accuracy, cost, and convenience with lower overall risk, then it has just as much cause to be considered. Lastly, utilizing techniques that allow high-quality imaging with lower radiation exposure should be continually used when available to achieve safer imaging.

The authors ultimately conclude that the implementation of these strategies will be necessary to achieve high-quality, patient-centered imaging, and will require a shared effort and investment by all stakeholders, including physicians, patients, politicians, industry leaders, and scientific organizations to steer its priority.

Clinical Topics: Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Interventions and Imaging, Angiography, Computed Tomography, Nuclear Imaging

Keywords: Radiation, Safety, Coronary Angiography, Tomography, X-Ray Computed, Investments, Diagnostic Imaging, American Heart Association, Risk Assessment

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