Diagnostic Imaging: Appropriate and Safe Use.

Area of Science:

• Radiology
• Medical Imaging
• Patient Safety

Background:

• Diagnostic radiography use has doubled in 20 years.
• Multidisciplinary initiatives like Image Gently and Image Wisely aim to reduce radiation exposure.
• Specific patient conditions (e.g., low GFR) increase risks with contrast agents.

Purpose of the Study:

• To provide guidance on appropriate diagnostic imaging selection.
• To highlight best practices for minimizing radiation exposure.
• To inform clinicians on imaging choices for various clinical scenarios.

Main Methods:

• Review of current guidelines and literature.
• Application of American College of Radiology Appropriateness Criteria.
• Discussion of imaging modalities for specific conditions (stroke, chest pain, appendicitis, etc.).

Main Results:

• Noncontrast head CT is first-line for suspected stroke; MRI and CT perfusion offer further evaluation.
• Cardiac CT angiography, stress echo, and nuclear stress tests are comparable for low-intermediate risk chest pain.
• CT pulmonary angiography is preferred for high-risk PE; V/Q scan for specific contraindications.

Conclusions:

• Appropriate imaging selection is vital for effective diagnosis and minimizing risks.
• Guidelines and criteria aid in optimizing imaging choices for diverse patient presentations.
• Avoiding unnecessary imaging, especially for uncomplicated headache or low back pain, is recommended.