Organizers expand scope of Image Gently radiation reduction program

The Alliance for Radiation Safety in Pediatric Imaging is expanding the scope of its Image Gently awareness efforts. The move to protect patients from unnecessary exposure to imaging-related ionizing radiation includes the participation of CareCore National, a radiology benefits management company that will apply its guidelines to a member network of 28 million people.

The Bluffton, SC, company will require network members to use appropriate radiation doses for pediatric CT scans. In an Oct. 22 statement, CareCore vowed to help Alliance efforts by ensuring that all of its radiologists follow the Image Gently child-size imaging guidelines. It also urged imaging facilities that bill its insurance clients to secure American College of Radiology accreditation.

CareCore manages radiology services for about 25 health insurers covering about 28 million beneficiaries. Its clients include Aetna, HealthNet, United Healthcare, and Blue Cross and Blue Shield plans in New Jersey and Alabama.

The Alliance was launched by the Society for Pediatric Radiology, American College of Radiology, American Society of Radiologic Technologists, and American Association of Physicists in Medicine. This charter group, which represents about half a million medical professionals, launched the Image Gently campaign to raise awareness about the need to child-size radiation doses from pediatric CT scans to reduce the possible harmful effects of cumulative exposure over time.

Since the campaign's public launch in January 2008, more than 1500 medical professional have taken the multifaceted Image Gently Pledge to minimize radiation exposure for children.

Dr. Donald P. Frush, chair of the ACR Pediatric Commission and a member of the Alliance's steering committee, outlined the program's expansion plans in an interview with Diagnostic Imaging. The campaign was originally designed to reach technologists, imaging physicists, and radiologists, but the scope has been expanded to reach individuals, groups, and agencies involved in pediatric healthcare around the world, Frush said.

 

Frush cited several Alliance aims:
 

• Expanding outreach efforts beyond CT to include nuclear medicine, fluoroscopy, angiography, and radiography. Preliminary subcommittees have been formed with their respective leadership and plan to start operations in 2009.
   
• Preparing, in partnership with the American Academy of Pediatrics, a brochure on radiation safety for the parents of young patients.
   
• Reaching a wider pediatric subspecialty audience such as surgeons and cardiologists.
   
• Broadening the Image Gently scope outside pediatric and into adult imaging.
   
• Expanding its international scope as already reflected in collaborations with the Canadian Association of Radiologists, Sociedad Latino Americana de Radiología Pediátrica, Asian-Oceanic Society for Paediatric Radiology, Royal Australian and New Zealand College of Radiology, and European Society of Paediatric Radiology.
  
   

Some ideas remain in the embryonic stage and require careful planning and decision making, but they are being actively discussed at this time, Frush said. He pointed out that the thoughtful planning and contributions of the founding organizations and their leadership have led the campaign to a resounding success and have also encouraged members to keep thinking big.

 

"Both from an individual and from an organizational basis, (the campaign) has been able to maintain its momentum and address its original objectives, which are to improve or to maintain excellent image quality and diagnostic information with strong consideration in managing radiation dose," Frush said.

CareCore National has mandated each member group to have at least one physician sign on to the Image Gently campaign and incorporate all of the program's principles into its practice, said CareCore vice president and senior medical director Dr. Joel Canter.

While Image Gently guidelines will not be a part of CareCore's preauthorization process, individual groups will have to participate in the educational and awareness campaign to be allowed in the network, he said.

"When we do our biennial site review, we will check to make sure that all of the requirements of the program have in fact been incorporated within each of the groups," Canter said.

The biggest cause for inappropriate radiation is the failure of CT scanners to use child-size protocols or the imposition of adult-like imaging protocols. To make sure kids get only the proper radiation doses, CareCore will encourage group physicists to set machines to pediatric standards. It will also ask radiologists to follow Image Gently ideas, such as performing single scanning instead of multiple series and focal rather than global imaging.

"Adult scanning protocols for pelvic indications typically include the entire abdomen and pelvis. Image Gently suggests that if a child has a problem in the pelvis, only the pelvis be scanned and not the entire abdomen," Canter said.

For more information from the Diagnostic Imaging archives:

Image Gently alliance pushes pediatric radiation dose standardsPediatric imagers put dose campaign on the roadEmergency room CT scanning of teenagers skyrocketsImage Gently alliance seeks to reduce pediatric CT radiation dose