Single X-Ray Sufficient
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Researcher draws conclusion Single X-ray sufficient By SALLY REESE Times Medical Writer How many X-rays are required for a particu-lar examination? Not as many as you may get, says Dr. Ronald L. Eisenberg, who studied the question in 1977-79. the chairman of radiology at LSU Medical Center found that in patients receiving routine chest X-rays, a single particular radiographic view is sufficient for accurate diagnosis. In ex-aminations of cervical and lumbar spine for suspected degenerative disease or old injury, two is enough. The significance to patient costs and radiation exposure is remarkable, he says. Eisenberg did the 18-month study in the VA Hospital in San Francisco where he was associate chief of the radiology service. He was with the University of California School of Medicine at the time. The research was undertaken to determine the optimum number of radiographic (X-ray) projections needed to assess applicants for VA compensation for chest disease and possible de-generative disease or old injury of the cervical and lumbar spine. It was supported by a grant from the VA. Three separate readings were made for each clinical problem, and for each reading the number of projections was varied. Results showed that in 99 percent of chest examinations the final radiographic diagnosis could have been made from a single post-eroanterior view. In 100 percent of the cervical and lumbar examinations, assessment could have been made from anteroposterior and lateral views. Applying these results to data on compensa-tion examinations performed in the entire VA system for the fiscal year 1978, Eisenberg con-cluded that limiting the screening X-ray examina-tion of the chest to a single posteroanterior view would eliminate 150,000 radiographs in the eval-uation of 190,000 applicants for compensation and save the VA almost $900,000. As for the cervical and lumbar spines, it was concluded that the VA could eliminate 193,000 radiographs in the evaluation of 100,000 applicants for compensation at a savings of about $1 million. In a paper presented before the American Roentgen Ray Society last April, Eisenberg says these results are consistent with "the radiologist's goal to devise methods to decrease health care costs and radiation exposure without sacrificing diagnostic accuracy." While emphasizing that they refer specifically to chest, lumbar and cervical spine examinations of patients applying for compensation within the VA, Eisenberg says the findings apply to other medical institutions and clinical settings as well. "An estimated 65 million radiographic ex-aminations of the chest are performed yearly in the United States," he says. "In those routinely made for screening purposes, one posteroanterior view should be sufficient for accurate diagnostic interpretation. When extrapolated to the national level, the potential saving in manpower, health costs and radiation exposure should be enormous." Medical overuse of X-ray is of concern to health care professionals as well as patients, Eisenberg says. It can be the result of excessive irradiation per radiograph, excessive examina-tions per patient, or excessive radiographs per examination. "Excessive irradiation per radiograph can be reduced with high quality radiographic equipment and appropriate training of technologists," he says.
|Title||Single X-Ray Sufficient|
Eisenberg, Ronald L.
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|Source||Louisiana State University Health Sciences Center Shreveport Medical Library (http://lib.sh.lsuhsc.edu)|
|Coverage-Spatial||Shreveport (Caddo, La.)|
|Rights||Physical rights are retained by Louisiana State University Health Sciences Center Shreveport. Copyright is retained in accordance with U.S. copyright laws.|