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Doctors’ knowledge of patient radiation exposure from diagnostic imaging requested in the emergency department

TO THE EDITOR: At a time of apparent increasing concern over radiation exposure, the article by Keijzers and Britton unfortunately does not provide any perspective on the clinical necessity of the imaging investigations requested by emergency department doctors. It also contains inaccurate information. Stating that “multidetector CT [computed tomography] scanners have the potential to expose patients to higher radiation doses”, and preceding it with “radiation doses per scan have increased by up to 40%”, is incorrect. CT scanner manufacturers have for some time been producing scanners that have decreased radiation doses by incorporating various techniques, including iterative reconstruction (a reconstruction algorithm that corrects image data by using various models, thereby improving CT image quality while reducing radiation dose). The dosage reductions reported by major manufacturers and in the literature vary between 25% and 80%. The efficacy of dose-reduction mechanisms and the concepts behind them have been outlined in numerous white papers and scientific articles, leading to the conclusion that “newer scanners have improved technology that facilitates lower patient doses”. In their seminal article, McCollough and colleagues caution that “alarmist articles” do the public a disservice. They also state that