Radiation Safety: A Priority at UCSF

The following article was written by Robert Gould, ScD, Professor of Radiology, Vice Chair of Radiology for Technology and Capital Projects at UCSF, Jack Lambert, PhD, Postdoctoral Fellow in CT Physics, & John Mackenzie, MD, Chief of Pediatric Radiology, Assistant Professor in Residence at UCSF.

We are all exposed constantly to radiation, mainly from the sun and soil. Other sources are man-made and include diagnostic imaging tests like X-rays, CT scans, and Nuclear Medicine studies. While there are benefits to the medical use of radiation, there are also possible negative health effects.  UCSF is a leader in adopting practices for the reduction of radiation in all of our patients, as Brett Elicker, MD explains in a video about how we reduce patient exposure to radiation:

At UCSF we take great care to protect patients from radiation. For example, we use shielding to reduce the radiation dose to certain body organs when we can. During general X-ray procedures the X-ray beam is carefully restricted to the area of clinical interest, a process called collimating.

We use CT protocols that adjust the dose of radiation depending on the patient size, the body part being imaged, and the reason for the study.  These protocols are routinely reviewed for each body part.  Specific protocols are used for pediatric imaging, which minimize dose for our youngest patients.

We are very concerned about radiation exposure to our pediatric population.  Several of our radiologists specialize in infant imaging.  When possible, we often recommend alternative imaging studies with ultrasound, which require no radiation at all.

UCSF follows the principle of "ALARA" (radiation dose As Low As Reasonably Achievable) when it comes to radiation and patient safety. That means we always use the lowest radiation dose consistent with getting imaging results that are of appropriate diagnostic quality.

In addition to protocols mentioned elsewhere, UCSF follows other new low-dose protocols for imaging, which include CT-guided spine procedures; low-dose CT for early detection of lung cancer; and low-dose coronary CT angiography.

UCSF’s Department of Radiology & Biomedical Imaging is fully committed to minimizing exposure to radiation for our patients and staff.  We maintain a Radiation Oversight Committee that oversees radiation-intense protocols and education regarding imaging algorithms to minimize exposure to radiation when possible.

Here are some other things we routinely do to ensure imaging is safe:

• We encourage referring physicians to consider tests that do not involve radiation (e.g., ultrasound or MRI) if they can provide the same information as a CT scan or other test with radiation.
• Quality control procedures are performed on a scheduled basis to assure that all X-ray imaging devices are operating correctly and safely.
• Radiation levels for CT and Interventional Radiology procedures are carefully monitored; if levels are exceeded, it will cause an immediate warning e-mail to be sent to the appropriate staff responsible for overseeing and following up on these exposures.
• All UCSF CT scanners are equipped with the latest generation automatic dose modulation software that reduces the radiation dose to various body parts during a scan.

It’s also important to note that training of personnel and the use of low-dose methods were integral factors in our CT scanners receiving accreditation from the American College of Radiology. We encourage patients to discuss with their doctors any concerns about the risks vs. benefits of radiation when an imaging test is ordered.

Radiologists in our department are available to discuss issues about radiation exposure and how we can reduce it.