NIH Clinical Center to Record Radiation Exposure

Journal of Nuclear Medicine, The, Oct 2009

On August 17 the Radiology and Imaging Sciences department at the National Institutes of Health (NIH) Clinical Center announced "a significant step to further safeguard clinical research patients at the NIH Clinical Center who are exposed to radiation during certain imaging tests." Beginning immediately, CT and PET/CT equipment purchased by the Clinical Center will be required to routinely and automatically record radiation dose exposure in a patient's hospital-based electronic medical record. "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. "The CJinicaJ Center's approach is an important first step in making it possible to more easily document and track information about a patient's exposure to radiation."

Most radiologic devices and radiology information systems do not collect or report radiation exposures. "CT and PET/CT scanners do not currently forward data on radiation dose to our radiology information systems," said David A. Bluemke, MD, PhD, director of Radiology and Imaging Sciences at the Clinical Center.

The news release accompanying the announcement emphasized the importance of tracking an individual's exposure to radiation through routine imaging tests "so that researchers can begin to determine if these exposures pose a health risk." Ronald Neumann, MD, chief of nuclear medicine and deputy associate director for imaging sciences at the Clinical Center, noted the recent National Council on Radiation Protection and Measurements report indicating that individuals in the United States received 7 times more radiation exposure from medical tests in 2006 than in the 1980s. "CT and cardiac nuclear medicine studies accounted for much of this increased medical radiation exposure," he said. "Recording radiation dose is technically possible and an ethical imperative."

The NIH Clinical Center also will require that newly purchased equipment allow patients to record their radiation dose exposure in their own personal health records. The NIH Clinical Center's imaging program staff will work with vendors who supply their imaging equipment to develop software tools to extract examination type, date, and radiation dose exposure for uploading to a personal health record. About 25,000 CT and 1,250 PET/CT scans are performed at the Clinical Center each year as part of NIH research protocols. The clinical research hospital currently houses 5 CT scanners and 2 PET/CT scanners.

The press release noted that "ultimately, radiation dosage could become a standard element of a universal electronic medical record used to assess radiation risk from life- long medical testing." Both industry and practice observers from outside NIH noted the strong possibility mat within the decade similar record-keeping could be required in all NIH-funded research and clinical trials.

National Institutes of Health