Diminishing the Risks of Imaging with an Established Safety Plan

In the UCSF Department of Radiology and Biomedical Imaging, we don’t ignore the facts. The fact is there are risks to medical imaging. While MRI accidents are rare, they can happen.  A patient undergoing a CT scan is at risk of receiving too much radiation if a procedure is conducted improperly or unnecessarily. It’s necessary that pediatric patients receive the lowest possible doses of radiation.

Other potential risks of medical imaging include negative reactions to contrast agents, the substance used to enhance the contrast of structures or fluids within the body in medical imaging, and procedures that are done without proper safe scanning protocols. Finally, imaging exams have the potential to discover an unknown health concern, causing additional stress, and conversely, not finding what is sought after, leading to repeat scans.

But imaging comes with many benefits that must be considered when discussing risks. Generally speaking, all medical procedures and tests carry both risks and benefits, and any consideration of radiation or safety risk must be balanced against the benefits.

For example, imaging answers worrisome health care questions, resulting in better peace of mind. Imaging often leads to a reduction of concerns for patients. And without medical imaging, the first step in a care plan cannot be made.

When considering any kind of imaging for yourself or a loved one, how do you know you’re choosing an institution that can meaningfully apply its expertise so patients get the best treatment?

Safety comes from expertise. For a radiology clinic or department, that means not just the institutional memory of having performed multiple procedures, or even just each member of the radiology team’s individual experience. Those many levels of experience should be actively incorporated into a continually reviewed and applied safety plan. And team members who serve patients day in and out must be empowered to act on that plan.

Imaging to identify the source of back pain is a great example of how a developed and applied safety plan is necessary.  Imaging is performed frequently to diagnose back pain, and there can be a multitude of findings. MRI results from a patient with no back issues will still show abnormalities frequently seen on the results of patients with back pain. The radiology team must understand the prevalence of these abnormalities, such as how the normal aging process has affected spine health. Team members also must review medical records and consult with referring physicians. Expertise can reveal what kind of imaging a patient needs. The cookie cutter MRI for back pain is a lumbar spine MRI, but if an abnormality is more localized to the nerves, the more appropriate approach is a neurogram.

An institution that has integrated its expertise through all levels of treatment can make that decision in real-time and avoid repeated scans. Finally, perhaps most critically, the patient’s experience must be taken into consideration. When a patient comes to UCSF Radiology with back pain, we ask where the pain is and mark that before the scan. A quarter to half the time, we will see something in the scan that suggests a different treatment approach. This not only saves future scans, but gets the patient feeling better right away.

This is just one example of how patient safety guidelines are implemented and adhered to at all time by UCSF radiologists and personnel. When considering the risks of imaging, it’s necessary to consider both the benefits of the procedure, as well as the radiology department’s ability and expertise of applying an established and maintained safety plan.  In the UCSF Department of Radiology and Biomedical Imaging, we are committed to maintaining the highest possible standards of patient care and safety, from the moment a test is requested through to performance and final reporting of an imaging examination.

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