NIH to place CT, PET/CT radiation exposure in patients EMRs

Radiology and Imaging Sciences at the National Institutes of Health (NIH) Clinical Center is hoping to safeguard its clinical research patients from radiation exposure by requiring CT and PET/CT equipment purchased by the NIH Clinical Center to be routinely record exposure dose in a patient's hospital-based EMR.

"When a hospital or clinic patient receives a medication or a treatment, it is routinely recorded in the patient's medical record," said John I. Gallin, MD, director of the Clinical Center, NIH's clinical research hospital in Bethesda, Md. He added that the Clinical Center's approach will make it possible to “more easily document and track information about a patient's exposure to radiation.”

"CT and PET/ CT scanners do not currently forward data on radiation dose to our RIS," said David A. Bluemke, MD, PhD, who is director of radiology and imaging sciences at the NIH Clinical Center.

The risk of exposure to low doses of radiation from diagnostic medical imaging tests is unknown, but very high radiation doses have the potential to cause cancer, according to NIH. The ability to keep track of an individual's exposure to radiation through routine imaging tests is needed, so researchers can begin to determine if the exposures pose a health risk.

"The National Council on Radiation Protection and Measurements reported recently that Americans received seven times more radiation exposure from medical tests in 2006 than was the case in the 1980s," said Ronald Neumann, MD, chief of nuclear medicine and deputy associate director for imaging sciences at the NIH Clinical Center. "CT and cardiac nuclear medicine studies accounted for much of this increased medical radiation exposure."

Ultimately, radiation dosage could become a standard element of a universal EMR used to assess radiation risk from life-long medical testing, the NIH Clinical Center radiologist said. "Recording radiation dose is technically possible and an ethical imperative, " Neumann said.

The NIH Clinical Center's imaging program will work with vendors who supply its imaging equipment to develop software tools to extract the exam type, date and radiation dose exposure from the study and include it on the patient's CD-ROM. ASNC Nuclear Cardiology Physics Course Registration Form At that point, it will be possible to upload the information to a personal health record.

Both the American College of Radiology (ACR) and the Radiological Society of North America (RSNA) have recommended that patients keep a record of their x-ray history, NIH said.

About 25,000 CT and 1,250 PET/CT scans are performed at the NIH Clinical Center each year as part of NIH research protocols. The clinical research hospital currently houses five CT scanners, and two PET/CT scanners.

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