To scan or not to scan

The question that we all have, to scan or not to scan?

But, did you know…

X-rays were an accidental discovery in 1895, by Professor Wilhelm Roentgen.

The ‘X’ in X-ray refers to the unknown.

Hence, Prof Roentgen did not know what type of rays were producing the results. 

The magnets used in the magnetic field of an MRI machine are 140,000x stronger than the magnetic field of the earth.

 

To scan or not to scan is something all patients get confronted with at some time or another. Two of the most frequently asked questions regarding imaging is whether it is necessary and if it is dangerous to undergo imaging. Within this article we discuss these questions that you have. We also discuss the benefits of reliable imaging, and dive deeper into the most common fears related to receiving treatment using imagery. Read more where we provide you with a clearer understanding between the different types of imaging screening and their indented uses. 

 

When is a scan needed?

Research indicates that there is not always a correlation between symptoms and findings on the scans. What does this mean? Well, a patient can have symptoms (i.e, pain) but the scans are clear. The reverse is also true, a patient might be asymptomatic (i.e, without symptoms) but there are findings of pathology on the scans. With that being said, the helpfulness of imagery is definitely dependent on each patient and their condition, symptoms and circumstances.

As mentioned, the need for diagnostic imagery is specific to each patient and condition. For example, a patient with scoliosis requires x-rays to be taken at least once a year to monitor their condition. These diagnostic imagery not only allows healthcare practitioners to determine the effectiveness of the current treatment plan, but it also provides the opportunity to plan ahead. One thing that is certain is that diagnostic imagery can be very effective if used correctly. In this example, diagnostic imagery can assist in the early detection and effective treatment of scoliosis.

 

 

More questions answered about scans:

Does every patient need to go for medical imaging for any or all conditions? The quick answer is NO, only when it is necessary & appropriate and required by your healthcare practitioner to make informed clinical decisions. There are certain conditions which are do not allow the patient to undergo medical scans for safety reasons. However, your health care practitioner will advise acordingly.

How many times can a patient be referred for medical imaging scans? The amount is unlimited, as long as the scans / treatments occur with enough time between appointments. Are children/ pregnant women/ elderly allowed to undergo scans? YES, only when it is necessary & appropriate to make informed clinical decisions.

Will imagery screenings cause a risk for cancer or other chronic conditions to develop? NO, multiple studies have shown that low doses of spread-out radiation exposure do not cause cancer but can have a positive effect on the body.

 

The difference between X-rays, Ultrasound, CT-scans, and MRI’s

X-rays: 

Make use of radiation rays to identify broken bones, bone deformities & conditions such as osteoporosis and scoliosis. They can also be used to identify tumors and inflammations.

 

 

 

Ultrasound: 

This type of screening is used to evaluate soft tissues such as muscles, ligament, tendons, and blood vessels. Ultrasounds can also be used to monitor the growth of a fetus and to evaluate the heart.

 

 

 

CT-scan: 

A computerised tomography (CT-scan) provides a fast series of X-rays that show a deeper and more detailed image of the area needing treatment. It makes use of a multi-angle cross sectional screening report.

 

 

 

MRI: 

Magnetic resonance imaging (MRI) allows healthcare practitioners to evaluate the brain and soft tissues using a magnetic field. An MRI is requested by a healthcare practitioner (HCP) when all the above-mentioned screenings did not detect the problem. It provides a 3-dimensional view that cannot be gained from an X-ray.

 

 

 

 

Appropriateness of medical imagery screening for diagnostics

For these tests and screenings to be effective, they must be used appropriately. A scan is seen as appropriate when the evidence-based benefit outweighs the risk. With that being said, we need to understand that underuse, misuse, and overuse of medical imagery can still occur.

Underuse can not only lead to a missed diagnosis and in turn delay the application of the required treatment, but it can also lead to the incorrect treatment being prescribed.

Misuse refers more to when improper dosages and exposure is requested. This can be due to missed communication between HPC’s & double investigations- leading to a greater risk of negative outcomes and more medical expenses for the patient.

Overuse happens when there is referred for medical scan when it is not needed to determine the diagnosis or implement the correct treatment. As with misusing medical scans- overuse can contribute to increasing medical expenses and unnecessary negative exposure. Overuse not only influences the patient but radiology HCP as well- increasing their overall workload and even hindering them to focus on the more urgent patients.

Used appropriately occurs when the healthcare practitioner refers for a scan when it is needed in onrder to make clinical decisions or to monitor an already diagnosed condition such as scoliosis.

 

 

Benefits of medical imagery

• Improved diagnosis precision
• Early detection of conditions/ diseases
• More effective treatment applications aligned with scan results
• Improves antioxidant capacity of cells
• Stimulation of the body’s immune systems
• Reduced medical cost of extra investigations and exploration surgeries

 

Risks of medical imagery

• Ultrasound produce no risks
• When you have metal in your body (joint replacement/ dental implants), there are some risk involved with MRI scans and harmful outcomes should be discussed with HCP.
• X-rays and sonar do not pose a risk with low-dose radiation exposure

 

Factors influencing the effectiveness of medical imagery

• Equipment maintenance & calibrations
• Patient familiarity 
• Clinician experience
• Intra-practitioner differences

 

 

Fears associated with using imagery for treatment

1. Fear that all radiation scan & treatments cause cancer

When a patient goes for an X-ray, Sonar or MRI, they get exposed to radiation waves. These waves are permitted at low enough dosages that the harmful effects are lower than the benefits gained from the exposure. It is true that radiation exposure can break the chemical bonds between the molecules within our body’s cells and soft tissues and can cause damage to the DNA.

BUT we need to acknowledge the fact that low dose radiation exposure has shown to stimulate the body’s immune system. This means that after exposure the body can heal the minimal chemical damages within the next 24 hours and have helpful and positive effects on soft tissues and organs.

Some inflammatory conditions/ diseases are being effectively treated with low-dose radiation exposure called LDR therapy (low-dose ionizing radiation therapy).

2. Fear that the harmful and damaging effects of radiation accumulate to a total amount

We have some good news for you!

Research shows that damage to DNA due to low-dose radiation (X-rays & CT-scans) heals within the next 24 hours after exposure. So no, you cannot reach a maximal number of X-rays that you can undergo. It is important to understand that damage to the DNA will not have an accumulative effect unless the exposure/ tests are less than 24 hours apart.

3. Fear that children can be harmed more than adults through X-rays, CT-scans or MRI’s

As mentioned above and presented by evidence-based research- the positive benefits of clinical diagnostic imaging outweigh the ‘temporary’ damage to the body caused by the scans. When looking at the effect on children the outcome will be the same as long as the appropriate low-dose waves are being used. Research also presented that children and adolescents can benefit from low-dose medical radiographic treatments.