Imaging experts are becoming increasingly concerned that physicians are ordering too many unnecessary imaging tests, that are exposing patients to high levels of radiation and increasing the cost of health care.


They also said that many doctors order test diagnostic evaluations that will not determine the cause of their patients’ complains.  But improved communication among physicians and providing them with decision making-technology could decrease the ordering of these unnecessary tests.


According to Dr. William Hendee of the Medical College of Wisconsin in Milwaukee, “In most cases an imaging procedure enhances the accuracy of a diagnosis or guides a medical treatment and is fully justified because it benefits the patient.


“But some imaging procedures are not justified, because they are unnecessary for the patient’s care.  These are the uses of imaging that we see, as medical physicists, radiologists, radiation oncologists and educators, are trying to identify and eliminate.”


Unnecessary scans are costly and have been a concern among policymakers for the past few years, which have caused a decrease in Medicare reimbursement.  Recent research studies on radiation risk from CT (computed tomography) scans, and several accidental incidents of radiation overdoses have prompted new focus on medical imaging.


A 2009 report by the National Council on Radiation Protection and Measurement determined that Americans, compared to 1980 currently receive seven times more radiation from diagnostic scans.


Hendee says there are many reasons for overuse of medical imaging (MRI, PET scans). Two reasons for overuse-physicians who refer patients for scans at their own imaging facilities and those who seek to protect themselves gain potential malpractice lawsuits, require broad solutions.


Radiologists can educate physicians ordering the tests, and assist them in determine which scan is appropriate and when to order it.


“Often they do not know the right criteria for requesting a study,” Hendee said.  The American College of Radiology has developed appropriateness guidelines, but unfortunately many physicians are unaware that they exist.


Large hospitals have developed decision support software that assists the doctors ordering the scans in deciding which tests are indicated for their patients’ complaint.


He also noted that patients often request specific imaging tests, and physicians need to take the time to explain why the test is a waste of their money.