CT Radiation Exposure


Cottage takes radiation exposure seriously. The following is based on an article by  Dr. Steven Hartzman, board-certified staff radiololgist at SBCH and the Cottage Center for Advanced Imaging, discussing CT radiation exposure policy.



Radiation Exposure

Exposure to radiation from advanced CT (computed tomography) scanners has been a topic of professional study and concern for many years. The subject has received broader attention recently following the highly publicized events of the tsunami and subsequent nuclear power plant disaster in Japan and numerous over-exposure cases during brain perfusion CT scans at several U.S. hospitals.


In 2009 at Cedars-Sinai Hospital in Los Angeles, more than 200 patients received radiation doses eight times the manufacturer's recommendation as a result of improper scan settings programmed by CT technicians.

Dr. Steven Hartzman



Forty percent of those patients developed localized hair loss and / or skin erythema (redness). Similar errors and outcomes were identified at two other California hospitals. The FDA subsequently required all CT scanners nationwide be tested for proper settings and radiation output, as well as re-evaluation of all CT testing protocols.


In 2000, 30 million CT exams were performed, increasing to 62 million in 2006, and then 95 million in 2010. By 2012, CT exams in this country will exceed 125 million. In 2006, CTs comprised 14 percent of all radiology / nuclear medicine imaging procedures but resulted in over 50 percent of all imaging radiation exposure. In 2012 this is expected to increase to 70 percent.


Although much of this growth in CT is legitimate, many utilization studies show that up to 40 percent may be done for questionable indications. Many requests are driven by patient insistence to allay anxiety; defensive medicine (up to 25 percent in some studies); self-referral; and physicians unsure of correct tests to order.




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Perfusion Scan

Computed Tomography
Brain Perfusion
is used to evaluate blood flow
to the brain in suspected
ischemia and stroke.