← Back to Search
Radiation Risks Of Medical Imaging: Separating Fact From Fantasy.
W. Hendee, M. O’Connor
Published 2012 · Medicine
Download PDFAnalyze on Scholarcy
During the past few years, several articles have appeared in the scientific literature that predict thousands of cancers and cancer deaths per year in the U.S. population caused by medical imaging procedures that use ionizing radiation. These predictions are computed by multiplying small and highly speculative risk factors by large populations of patients to yield impressive numbers of "cancer victims." The risk factors are acquired from the Biological Effects of Ionizing Radiation (BEIR) VII report without attention to the caveats about their use presented in the BEIR VII report. The principal data source for the risk factors is the ongoing study of survivors of the Japanese atomic explosions, a population of individuals that is greatly different from patients undergoing imaging procedures. For the purpose of risk estimation, doses to patients are converted to effective doses, even though the International Commission on Radiological Protection warns against the use of effective dose for epidemiologic studies or for estimation of individual risks. To extrapolate cancer incidence to doses of a few millisieverts from data greater than 100 mSv, a linear no-threshold model is used, even though substantial radiobiological and human exposure data imply that it is not an appropriate model. The predictions of cancers and cancer deaths are sensationalized in electronic and print public media, resulting in anxiety and fear about medical imaging among patients and parents. Not infrequently, patients are anxious about a scheduled imaging procedure because of articles they have read in the public media. In some cases, medical imaging examinations may be delayed or deferred as a consequence, resulting in a much greater risk to patients than that associated with imaging examinations. © RSNA, 2012.
This paper references
Shifting the Paradigm in Radiation Safety
M. Doss (2012)
The Nobel Prize in Physiology or Medicine 1946-Presentation Speech
J Hermann (2011)
Whole-body responses to low-level radiation exposure: new concepts in mammalian radiobiology.
L. Feinendegen (2007)
The linear nothreshold rela tionship is inconsistent with radiation bio logic and experimental data. Radiology 2009;251(1):13–22
M Tubiana (2009)
The linear no-threshold relationship is inconsistent with radiation biologic and experimental data.
M. Tubiana (2009)
American Association of Physicists in Medi cine. Position statement of the American Association of Physicists in Medicine Radi ation risks from medical imaging proce dures
AMERICAN ASSOCIATION OF PHYSICISTS IN MEDICINE.
M. Bronskill (2012)
Radiation Risk and Ethics
Z. Jaworowski (1999)
Subjective Perception of Radiation Risk
L. Freudenberg (2011)
Chernobyl: Myth and Reality
Warren K. Sinclair (1996)
Computed tomogra phy: an increasing source of radiation expo sure
DJ Brenner (2007)
Radi ation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study
MS Pearce (2012)
The Society for Pediatric Radiology. Image Gently. http://www.pedrad.org/associations
Impact of reduced patient life expectancy on potential cancer risks from radiologic imaging.
D. Brenner (2011)
Low-dose radiation risk extrapolation fallacy associated with the linear-no-threshold model
B. Scott (2008)
Radiation Effects Research Foundation
A review of the healthy worker effect in occupational epidemiology.
C. Li (1999)
Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study
M. Pearce (2012)
Studies of mortality of atomic AnnuAl OrAtiOn: Radiation Risks of Medical Imaging Hendee and O'Connor Radiology: Volume 264: Number 2—August 2012 n radiology.rsna.org 321 bomb survivors
Dl Preston (1950)
The Linear No-Threshold Model does not Hold for Low-Dose Ionizing Radiation
A. M. Hooker (2004)
National Council on Radiation Protection and Measurements. Ionizing radiation exposure of the population of the United States
Muller’s Nobel lecture on dose–response for ionizing radiation: ideology or science?
E. Calabrese (2011)
Radiation-Related Cancer Risks at Low Doses among Atomic Bomb Survivors
D. Pierce (2000)
Mortality and cancer incidence following occupational radiation exposure: third analysis of the National Registry for Radiation Workers
C. Muirhead (2009)
The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103.
J. Valentin (2007)
Health Physics Society. Position statement of the Health Physics Society. Radiation risk in perspective
Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography.
A. Einstein (2007)
CHERNOBYL TEN YEARS ON RADIOLOGICAL AND HEALTH
France H Dr P Métivier Ipsn (1995)
Radi ation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lan cet
Ms Pearce (2012)
Risk of cancer from diagnostic X-rays: estimates for the UK and 14 other countries
A. González (2004)
[Thyroid cancer in children and adolescents].
Héctor Eloy Tamez-Pérez (2004)
The Society for Pediatric Radiology
W. Berdon (2005)
Computed tomography--an increasing source of radiation exposure.
D. Brenner (2007)
The 2007 recommendations of the Interna tional Commission on Radiological Protec tion. ICRP publication 103 Radiationrelated cancer risks at low doses among atomic bomb survivors
Subjective per ception of radiation risk
LS Freudenberg (2011)
Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII Phase 2
Division on Earth (2006)
Effective doses in radiology and diagnostic nuclear medicine: a catalog.
F. Mettler (2008)
Report 13: solid cancer and noncancer disease mortality: 19501997
D L Preston (2003)
Projected cancer risks from computed tomographic scans performed in the United States in 2007.
A. Berrington de González (2009)
The Nobel Prize in Physiology or Medicine 1946–Presentation Speech
Hermann J Muller (2011)
Thyroid cancer after exposure to external radiation: a pooled analysis of seven studies.
E. Ron (1995)
Nobel prize in physiology or medicine.
J. Meites (1978)
Studies of Mortality of Atomic Bomb Survivors. Report 13: Solid Cancer and Noncancer Disease Mortality: 1950–1997
D. Preston (2003)
Solid Cancer Incidence in Atomic Bomb Survivors: 1958–1998
D. Preston (2007)
Is computed tomography safe?
R. Smith‐Bindman (2010)
Nuclear Energy Agency, Organization for Economic Cooper ation and Development
Position statement of the Health Physics Society. Radiation risk in perspective
This paper is referenced by
Guidance for computed tomography (CT) imaging of the lungs for patients with cystic fibrosis (CF) in research studies.
M. van Straten (2019)
Radiation risk index for pediatric CT: a patient-derived metric
E. Samei (2017)
Radiation exposure in adult and pediatric patients with osteogenesis imperfecta.
Jordan D. Perchik (2019)
Percutaneous Renal Tumor Ablation: Radiation Exposure During Cryoablation and Radiofrequency Ablation
James C. McEachen (2015)
Dosis und Dosisreduktion in der Computertomografie
Michael M. Lell (2017)
Shared decision-making: is it time to obtain informed consent before radiologic examinations utilizing ionizing radiation? Legal and ethical implications.
L. Berlin (2014)
Social-Ecological Factors Affecting Patient Shield Use Among Radiologic and Computed Tomography Technologists
Megan Housenick-Lee (2017)
Dose Reduction and Dose Management in Computed Tomography - State of the Art.
D. Zinsser (2018)
Chest Tomosynthesis for Detection and Surveillance of Pulmonary Pathology. Studies on Cystic Fibrosis and Solid Pulmonary Nodules
Carin Meltzer (2019)
Clinical application of radiation dose reduction at abdominal CT.
T. Higaki (2019)
Patient perspectives and preferences for communication of medical imaging risks in a cancer care setting.
R. Thornton (2015)
Lung Cancer: Diagnosis and Treatment Approach
Apichat Tantraworasin (2015)
Les faibles doses de radiations : vers une nouvelle lecture de l’évaluation du risque ?
A. Perez (2015)
Image Gently: Minimizing Radiation Exposure in Children
Linda A. Heier (2017)
Cancer induced by exposure to ionizing radiations in medical personnel
Xenia Elena Bacinschi (2018)
UC Office of the President Recent Work Title California Breast Cancer Prevention Inititiatives : Setting a research agenda for prevention Permalink
M. H. E. Kavanaugh-Lynchb ()
Managing radiation dose from thoracic multidetector computed tomography in pediatric patients: background, current issues, and recommendations.
R. MacDougall (2013)
Risk of Radiation-Induced Cancer From Computed Tomography Angiography Use in Imaging Surveillance for Unruptured Cerebral Aneurysms
A. Malhotra (2018)
Monte Carlo calculations of patient organ doses in Toshiba computed tomography examinations with automatic tube current modulation: A feasibility study
Daniel Jerad Long (2013)
Radiation risks of medical imaging.
Mervyn D. Cohen (2013)
Demonstration of the Effect of Generic Anatomical Divisions versus Clinical Protocols on Computed Tomography Dose Estimates and Risk Burden
Rachael E Moorin (2014)
The Clinical Impact of Accurate Cystine Calculi Characterization Using Dual-Energy Computed Tomography
William E. Haley (2015)
Toward a New Paradigm for Risk-Based Radiation Policymaking
Thomas Hansen (2019)
Cumulative radiation exposure from diagnostic imaging in intensive care unit patients.
F. Moloney (2016)
Image Gently: toward optimizing the practice of pediatric CT through resources and dialogue
D. Frush (2015)
Dose tracking and rational examination selection for the medically-exposed population.
James A. Brink (2014)
Molecular Breast Imaging for Screening in Dense Breasts: State of the Art and Future Directions.
Carrie B. Hruska (2017)
Radiation dose optimization in interventional radiology and cardiology using diagnostic reference levels
De Vos (2016)
Automated and objective removal of bifurcation aneurysms: Incremental improvements, and validation against healthy controls.
Aslak Wigdahl Bergersen (2019)
Radiation risk and protection of patients in clinical SPECT/CT
G. Brix (2013)
Estimated radiation risk of cancer from dental cone-beam computed tomography imaging in orthodontics patients
Jih-Kuei Yeh (2018)
Works Title Computed Tomography Use for Adults With Head Injury : Describing Likely Avoidable Emergency
Ganesh Nagaraj (2017)See more