Appropriate and safe use of diagnostic imaging

Area of Science:

• Radiology
• Medical Imaging
• Radiation Safety

Background:

• Diagnostic imaging use has surged, increasing radiation exposure and associated risks like cancer.
• Gadolinium contrast media poses a risk of nephrogenic systemic fibrosis in patients with advanced chronic kidney disease.

Purpose of the Study:

• To review the risks associated with diagnostic imaging, including radiation exposure and contrast media complications.
• To provide guidance on appropriate imaging utilization to mitigate potential harms.

Main Methods:

• Review of current literature on diagnostic imaging risks and benefits.
• Analysis of trends in imaging volume and radiation exposure.
• Evaluation of specific imaging modalities and their indications.

Main Results:

• Computed tomography (CT) exposure is predicted to cause 2% of future cancers.
• Diffusion-weighted MRI is superior to CT for stroke evaluation between 3-24 hours.
• Specific imaging techniques offer advantages for appendicitis, cholecystitis, and urolithiasis in pregnancy.

Conclusions:

• Appropriate use of diagnostic imaging, guided by clinical guidelines, is crucial for risk reduction.
• Certain imaging modalities should be avoided or used judiciously in specific patient populations (e.g., CKD, chronic back pain).
• Evidence does not support the use of whole-body scanning.