"In summary, it is important and necessary to individually adapt the scan protocol, with the use of every possible strategy for dose reduction. A combination of several dose saving algorithms is often feasible and leads to an efficient reduction in the overall radiation dose for a cardiac CT study." "A combination of several dose saving algorithms is often feasible and leads to an efficient reduction in the overall radiation dose for a cardiac CT study."

Trends in radiation protection in CT: Present and future status
Bischoff B et al.
J Cardiovasc Comput Tomogr (2009) 3, Supplement 2, S65-S73

Education and Training for the"Team": The Best Radiation Dose Reduction Plan

In the article Image Gently: Ten Steps You Can Take to Optimize Image Quality and Lower CT Dose for Pediatric PatientsStrauss KJ et al. AJR 2010; 194:868-873 the authors clearly made step number one that of training and education was for the radiologic technologist. "1.Increase awareness and understanding of CT radiation dose issues among radiologic technologist"is a critical point that must not be overlooked. At the end of the day it is "your" technologist who selects or modifies the final scan protocol that will define dose. Some of the things to discuss with your technologist should include (but not limited to);

" The U.S. per capita annual effective dose from medical procedures has increased about sixfold (0.5 mSv (1980) to 3.0 mSv (2006)."

Radiologic and Nuclear Medicine Studies in the United States and Worldwide: Frequency, Radiation Dose, and Comparison with Other Radiation Sources-1950-2007
Mettler FA et al.
Radiology 2009; 253:520-531

"Worldwide estimates from 2000-2007 indicate that 3.6 billion medical procedures with ionizing radiation (3.1 billion diagnostic radiologic, 0.5 billion dental, and 37 million nuclear medicine examinations) are performed annually."

Radiologic and Nuclear Medicine Studies in the United States and Worldwide: Frequency, Radiation Dose, and Comparison with Other Radiation Sources-1950-2007
Mettler FA et al.
Radiology 2009; 253:520-531

"In the United States in 2006, about 377 million diagnostic and interventional radiologic examinations and 18 million nuclear medicine examinations were performed. The United States accounts for about 12% of radiologic procedures and about one-half of nuclear medicine procedures performed worldwide."

Radiologic and Nuclear Medicine Studies in the United States and Worldwide: Frequency, Radiation Dose, and Comparison with Other Radiation Sources-1950-2007
Mettler FA et al.
Radiology 2009; 253:520-531

"In summary, it is important and necessary to individually adapt the scan protocol, with the use of every possible strategy for dose reduction."

Trends in radiation protection in CT: Present and future status
Bischoff B et al.
J Cardiovasc Comput Tomogr (2009) 3, Supplement 2, S65-S73

"Cumulative CT radiation exposure added incrementally to baseline cancer risk in the cohort. While most patients accrue low radiation induced cancer risks, a subgroup is potentially at higher risk due to recurrent CT imaging."

Recurrent CT, Cumulative Radiation Exposure, and Associated Radiation-induced Cancer Risks from CT of Adults
Sodickson A et al.
Radiology 2009; 251:175-184

"Our results suggest that radiation dose and cancer risk of CT coronary angiography to pediatric patients are not negligible, more so in Hong Kong children than in U.S. children. Therefore, these examinations should be well justified clinically."

Pediatric 64-MDCT Coronary Angiography With ECG-Modulated Tube Current: radiation Dose and Cancer Risk
Huang B et al.
AJR 2009; 193:539-544

"Ongoing efforts to ensure that CT examinations are both medically justified and optimally performed must continue, and education must be provided to the medical community and general public that put both the potential risks—and benefits– of CT examinations in proper perspective."

In Defense of Body CT
McCollough CH et al.
AJR 2009; 193:28-39

"Conservative estimations of potential risk show that the potential risk of dying from undergoing a CT examination is less than that of drowning or of a pedestrian dying from being struck by any form of ground transportation, both of which most Americans consider to be an extremely unlikely event."

In Defense of Body CT
McCollough CH et al.
AJR 2009; 193:28-39

"In the final analysis, physicians must request the imaging examination that best addresses the specific medical question without allowing worries about radiation to dissuade them or their patients from obtaining needed CT examinations."

In Defense of Body CT
McCollough CH et al.
AJR 2009; 193:28-39

"Our purpose here is to discuss medical justification of the small potential risk associated with the ionizing radiation used in CT and to provide perspectives on practice specific decisions that can maximize overall patient benefits."

In Defense of Body CT
McCollough CH et al.
AJR 2009; 193:28-39

"LNT was a useful model half a century ago. But current radiation protection concepts should be based on facts and on concepts consistent with current scientific results and not on opinions. Preconceived concepts impede progress; in the case of the LNT model, they have resulted in substantial medical, economic and other societal harm."

The Linear No-Threshold Relationship Is Inconsistent with Radiation Biologic and Experimental Data
Tubiana M et al
Radiology 2009; 251:13-22

"Among humans, there is no evidence of a carcinogenic effect for acute radiation at doses of less than 100 mSv and for protracted irradiation at doses less than 500 mSv."

The Linear No-Threshold Relationship Is Inconsistent with Radiation Biologic and Experimental Data
Tubiana M et al
Radiology 2009; 251:13-22

"The fears associated with the concept of LNT (linear no-threshold model) and the idea that any dose, even the smallest, is carcinogenic lack scientific justification."

The Linear No-Threshold Relationship Is Inconsistent with Radiation Biologic and Experimental Data
Tubiana M et al
Radiology 2009; 251:13-22

"Irradiated cells protect themselves (a) by immediate defense, repair and damage removal mechanisms and (b) by delayed and temporary protection also renewed DNA damage, irrespective of its causes – that is through adaptive responses."

The Linear No-Threshold Relationship Is Inconsistent with Radiation Biologic and Experimental Data
Tubiana M et al
Radiology 2009; 251:13-22

"In summary, excess cancer risks obtained in the Japanese atomic bomb survivors and in many medically and occupationally exposed groups exposed at low or moderate doses are generally statistically compatible. For most cancer sites the dose response in these groups is compatible with linearity over the range observed."

Risks Associated with Low Doses and Low Dose Rates of Ionizing Radiation: Why Linearity May Be (almost) the Best We can Do?
Little MP et al
Radiology 2009; 251:6-12

Risks Associated with Low Doses and Low Dose Rates of Ionizing Radiation: Why Linearity May Be (almost) the Best We can Do?
Little MP et al
Radiology 2009; 251:6-12

VS

The Linear No-Threshold Relationship Is Inconsistent with Radiation Biologic and Experimental Data
Tubiana M et al
Radiology 2009; 251:13-22