Thursday, March 11, 2010

Ultrasound and CT: The Debate Continues

Many Americans are aware of the debate raging over the safety of CT scans performed. Issues regarding high radiation doses and appropriateness in the clinical setting have surfaced in recent months through out the media and in the blogosphere. The science behind radiation is clear: there is no such thing as a safe X-Ray. Medical professionals are taught in school that diagnostic X-Rays are to be used in the clinical setting when other, less hazardous forms of medical imaging will not give us the information we seek. Then why is it that when we go to the ED with an stomach pain we are sent to the CAT scanner instead of given an ultrasound? The answers are complex and troubling. In many cases the Physician trusts the result of the CT scan over the result of an ultrasound because they think the CT scan "Cannot miss anything". Many Physicians are under the impression that an ultrasound test is very operator dependent (True) and are loathe to trust the results for fear of being held liable if the test misses something. As a Sonographer, I agree that the results of the sonogram can be influenced by many factors including operator training and the skill of the interpretation, patient body habitus, and type of equipment used, but is CT really the gold standard? Should we really be subjecting our children and women of childbearing age to the risk of X-Rays without giving the matter much consideration? I would like to post part of an article I found on the web that discusses one of these issues. I welcome your feed back.

ScienceDaily (Mar. 8, 2010) — In a bold, eye-opening editorial in the March 2010 issue of the Journal of Ultrasound in Medicine, Harvard Professor, Beryl Benacerraf, MD, urges the medical community to use ultrasound instead of Computed Tomography (CT) as the first-line imaging test for better diagnosis capability in the evaluation of acute female pelvic and lower abdominal conditions.

"How have we evolved to ordering the most expensive imaging technique first for these patients, only to be followed frequently by a far less costly ultrasound examination to clarify the CT findings? Ultrasound is the established modality of choice to evaluate the female pelvis, so why do patients with pelvic masses or pain get a CT scan? In my opinion, doing a CT scan first for female patients with lower abdominal pain is dangerous and wasteful, a drain of much-needed health care dollars."
You can find the article here:

Thank you Science Daily.
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