December 12, 2022

ACR Medical Physics Experts Correct CT Dose Claims Published in JAMA Open

Image Gently Chair Joins Emergency Medicine Physicians In Separate Rebuttal


JAMA Network Open recently published a rebuttal comment from Mahadevappa Mahesh, MS, PhD, FACR, Chair of the American College of Radiology® Commission on Medical Physics, correcting a poorly supported claim in an article that stated, “individuals with 3 to 4 lifetime CT studies have similar cancer risks to that of nuclear bombing survivors in Japan. 

The journal also published comments submitted by Donald P. Frush, MD, FACR, chair, Image Gently Alliance, and emergency medicine physicians, Jennifer M. Frush, MD, and Andrew Mittelman, MD.

In the comment, (select “COMMENTS” at top right of the article), Dr. Mahesh and commission members Cynthia H. McCollough, PhD, and Ehsan Samei, PhD, called this passage “misleading and unnecessarily alarming.

The medical physics experts added that, “some bomb survivors received very high effective doses (several hundred mSv or more, where an increased incidence of cancer has been shown) and some received negligible amounts (<5 mSv, where increased risk has not been shown). Thus, comparing head CT recipients to atomic bomb survivors across such a wide range of doses is meaningless without context.”

Frush, et al, took issue with the statement by the JAMA paper authors that, “the use of CTH in patients with AMS was very high, but the positive yield on those CTH studies was low.” Frush and colleagues wrote that, “interpretations and resultant messages consisting of misrepresentation of radiation risk, provider awareness of risk, as well as overutilization only serve to unnecessarily promote radiation angst and obscure the high value of medical imaging, even when normal.”