CT Techniques: Risk and Challenges—Who Will Control Radiology




(1)
Department of Radiology, UMDNJ-New Jersey Medical School, Newark, NJ, USA

 



Abstract

Radiologists by obligation and by predilection are avid to be informed about new developments in diagnostic imaging. Yet a recurrent caveat in any promotion of a new technique is ever the present intrusion of unintended consequences which in actuality often become more profound and deleterious than the good they seek to invoke. Well I feel compelled to jump into the warning business. I must alert you to the harbingers of a gathering storm, or more appropriately, gathering storms, each of which will shower us with the insistent pressure of teeming rain or even the destructive power of small hailstones.


Radiologists by obligation and by predilection are avid to be informed about new developments in diagnostic imaging. Yet a recurrent caveat in any promotion of a new technique is ever present, the intrusion of unintended consequences which in actuality often become more profound and deleterious than the good they seek to invoke. I feel compelled to jump into the warning business. I must alert you to the harbingers of a gathering storm, or more appropriately, gathering storms, each of which will shower us with the insistent pressure of teeming rain, or even the destructive power of small hailstones.

What am I hyping here? Nothing less than a thunderous assault on the prestige of our specialty and its continued control of territory which is now being invaded both insidiously and directly by aggressive practitioners in cardiology and gastroenterology.

All of us know that too much of a good thing is bad. That goes for radiation as much as milkshakes. We enter the specialty with the foreknowledge that our pioneering forebears suffered grievously from the harmful effects of photons and radioactive isotopes on unprotected eyes, thyroid glands, limbs and lungs. Yet, today, as innovations using radiation have enlarged our capabilities, we tend to get caught up in the enthusiasm for their virtues, neglecting at the same time a careful accounting of their risks. Hence, we have enjoyed a generation- long explosion of CT use and only recently paid some heed to dose issues [1].

We also know that at least two steps in the general education of the public with respect to threats to their health must occur to galvanize change. Initially, and for a long time, there is often an awareness of scientific data which functions, apparently, like background noise within our collective consciousness. Except for the strident alarms of enthusiasts who warn us about the dire consequences of uncontained toxins and deviant policies, behavior and attitude are usually not affected. It is only when the press and government join together to impute either an emotional and/or a moral value to a particular carcinogen or irritant that public opinion is mobilized. Everyone knew in the 1950s that smoking caused cancer, but it took the Surgeon General’s report of 1964 to transmute the science into a reassessment of mores. More recently, throughout 1998 every baseball fan had learned by September that Mark McGuire was taking steroid supplements. It was only his appearance before a senate committee, convened in consequence of a collective sense of moral outrage about the unfair advantages of performance-enhancing pharmaceuticals, that his reluctance to acknowledge what everyone knew tainted his reputation and sullied his record.

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Apr 27, 2016 | Posted by in GENERAL RADIOLOGY | Comments Off on CT Techniques: Risk and Challenges—Who Will Control Radiology
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