This effort culminated in a 2006 CDC workshop that concluded that it would be extremely difficult to monitor actual doses received by patients.

The FDA recently published the Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging (http://www.fda.gov/downloads/Radiation-EmittingProducts/RadiationSafety/RadiationDoseReduction/UCM200087.pdf), aiming to promote safe use of medical imaging devices, support informed clinical decision making, and increase patient awareness.

Charles Miller proposed that the workshop participants consider the following question: Is now the appropriate time to reconsider the impact of radiation doses from medical procedures? Specifically:

1.   Can we measure and record real doses that patients receive?

2.   Can we track individual doses, and should we?

3.   How can we potentially use such data to inform decisions by patients and health care providers without interfering in the use of potentially life-saving medical procedures?

He emphasized that information about patient doses from medical diagnostic procedures today is based on estimates and not actual measurements. He provided an overview of the efforts that have been initiated during the past five years to raise awareness about radiation exposure in the United States, which include the Image Gently and Image Wisely campaigns. Without endorsing them, he mentioned the many web-based applications that encourage patients to keep records of their imaging exams and share the information with their doctor. Patients can easily enter the type of imaging they received, their age when they had the procedure and, assuming some standard effective dose for a procedure (e.g., 8 mSv for an abdominal CT exam) the applications calculate the induced risk.

Don Miller stated that any discussion on “whether,” “what,” and “how” to track exposure regarding CT, fluoroscopy, radiography, and nuclear medicine should be initiated with a clear understanding of the tracking’s purpose. Table 3.1 (adapted from Don Miller’s presentation) summarizes the information that in his view needs or does not need to be tracked to achieve the goal(s) of a tracking system. The four goals discussed were:

•   Justification

•   Optimization

•   Individual risk assessment

•   Research purposes

As an example, Don Miller explained that if the purpose of tracking is to help the physician, dentist, or other health care provider to decide



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