DOSE, BENEFIT, AND RISK IN MEDICAL IMAGING

Introduction
1. Essential Inquiries: Dose Benefit and Risk in Medical Imaging

Part I. Optimization and Dose Reduction in Medical Imaging
2. Radiation Dose Management
3. Nominal and Collective Radiation Dose in Medical Imaging: Critical Review of Survey Studies
4. Diagnostic Reference Levels
5. Optimization and Dose Reduction in Dentomaxillofacial Imaging
6. Optimization and Dose Reduction in Mammographic Imaging
7. Optimization and Dose Reduction in Fluoroscopy and Interventional Imaging
8. Optimization and Dose Reduction in Computed Tomographic Imaging
9. Optimization and Dose Reduction in Nuclear Medicine
10. Optimization and Dose Reduction in Hybrid Imaging: PET/CT and SPECT/CT
11. Optimization and Dose Reduction in Pediatric Medical Imaging
12. Optimization and Dose Reduction in Medical Imaging of the Pregnant Patient

Part III. Radiation Risks in Medical Imaging
13. Risks of Low-Level Exposure to Radiation – Biological Basis
14. Review of Current Radiation Risk Models As Related to Medical Imaging
15. Quantitative Benefit-Risk Analysis of Medical Radiation Exposures
Pat Zanzonico

Part IV. Medical Imaging: Safety Approach
16. Medical Imaging: Approach of the United Nations Scientific Committee on the Effects of Atomic Radiation

Part V. Patient Communications and Shared Decision-Making
17. Informed Decision Making in Medical Imaging
18. Communicating Risks and Benefits of Medical Imaging: The Patient Perspective

Conclusion
19. Essential Messages: Dose, Benefit, and Risk in Medical Imaging

This timely overview of dose, benefit, and risk in medical imaging explains to readers how to apply this information for informed decision-making that improves patient outcomes. The chapters cover patient and physician perspectives, referral guidelines, appropriateness criteria, and quantifying medical imaging benefits. The authors have included essential discussion about radiologic physics in medical imaging, fundamentals of dose and image quality, risk assessment, and techniques for optimization and dose reduction. The book highlights practical implementation aspects with useful case studies and checklists for treatment planning.
Clinicians, students, residents, and professionals in medical physics, biomedical engineering, radiology, oncology, and allied disciplines will find this book an essential resource with the following key features:
• Discusses risk, benefit, dose optimization, safety, regulation, radiological protection, and shared & informed decision-making.
• Covers regulatory oversight by government agencies, manufacturers, and societies.
• Highlights best practices for improving patient safety and outcomes.
• Gives guidelines on doses associated with specific procedures.

Authors
• Lawrence T. Dauer, PhD, DABHP is Corporate Radiation Safety Officer, Associate Attending Physicist, and Associate Clinical Member in the Departments of Medical Physics and Radiology at Memorial Sloan Kettering Cancer Center (MSKCC) in New York City. He earned an MS in Health Physics and a PhD in Adult Education. He is certified in comprehensive health physics by the American Board of Health Physics and is past chair of the Radiation Safety Committee of the American Association of Physicists in Medicine (AAPM), past President of the Greater New York Chapter of the Health Physics Society (HPS), Executive Council Member of the Medical Physics Section of HPS, a past Member of the Joint Safety Committee of the Society for Interventional Radiology and the American College of Radiology, past council member of the Radiological and Medical Physics chapter of AAPM, and a member of editorial and review boards of several scientific journals. He received the Elda E. Anderson Award from HPS in 2005, and was named an HPS Fellow in 2017. He is a Council member and serves on the Board of Directors of NCRP. He also served as a member of the International Commission on Radiological Protection Committee 3 on protection in medicine, a member of the science council for the International Organization for Medical Physics, and was on the program committee for the International Atomic Energy Agency’s International Conference on Radiation Protection in Medicine-Setting the Scene for the Next Decade. He serves on the Radiation Advisory Committee of the U.S. Environmental Protection Agency’s Science Advisory Board. He has several publications in the topical areas of radiation protection and risks in the fields of detection, radiology, interventional radiology, x-ray imaging, nuclear medicine, and radiation oncology, as well as surgery and medicine.
• Bae P. Chu is the Lead Health Physicist at Memorial Sloan Kettering Cancer Center (MSK). She earned her bachelor’s degree in Health Science at James Madison University and her master’s degree in Environmental and Occupational Health Science from Hunter College. She is a board-certified Radiation Technologist in the state of Maryland. Bae is currently working towards completing her Doctorate at the Graduate School of Public Health and Health Policy in New York. She has served on the executive board of the Greater New York Health Physics Society as President, Vice President to Toastmasters at MSK, and member of the American Industrial Hygiene Association. Her current academic research focuses on the perceptions of radiation isolation and interventions related to practice, training, and patient care that would impact engagement, safety, and quality of care.
• Pat Zanzonico received a BS in Physics from Cooper Union in 1977 and a PhD in Biophysics from the Cornell University Graduate School of Medical Sciences in 1982. He served on the faculty of the Department of Radiology (Nuclear Medicine) of the New York Hospital-Cornell Medical Center and is currently a Member and Attending Physicist at memorial Sloan Kettering Cancer Center, Co-Head of the Center's Small-Animal Imaging Laboratories, and Chairman of its Committee on Radiation. He also serves on the Special Contributing Faculty of the Gerstner Sloan-Kettering Graduate School and is an Adjunct Professor of Applied Physics and Mathematics at Columbia University. Dr. Zanzonico is Associate Editor of the British Journal of Radiology and the European Journal of Nuclear Medicine and a member of the Editorial Boards of the Journal of Nuclear Medicine and Medical Physics. He is also a member of the Medical Internal Radionuclide Dosimetry (MIRD) Committee of the Society of Nuclear Medicine and Molecular Imaging and past member and vice-chairman of the NRC’s Advisory Committee on Medical Uses of Isotopes (ACMUI), and a past Consultant to the International Atomic Energy Agency (IAEA). Dr. Zanzonico has over 120 peer-reviewed publications and over seventy-five invited presentations. He is actively involved in biomedical research on radionuclide-based methods for detecting and localizing tumor hypoxia, immune effector-cell trafficking, patient-specific dosimetry for radionuclide therapies, and small-animal and molecular imaging.