Radiation Overdoses from CT Perfusion

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Radiation Overdoses from CT Perfusion

Messaggiodi white il ven dic 18, 2009 11:59 am

Radiation Overdoses from CT Perfusion Brain Scans Spark FDA Investigation

CT perfusion imaging devices are giving patients severe radiation poisoning

When you go in for a medical imaging procedure, you're typically made to understand that there's some risk involved. Even mild procedures like chest X-Rays expose you to small doses of radiation that minutely increase your cancer risk. More advanced procedures can come with larger risks.

One such procedure is the CT perfusion scan, which involves injecting radioactive iodine into the blood stream and taking X-Rays for up to a minute of blood flow in the brain. The procedure is commonly used to diagnose strokes. Typically the biggest risk from the scan is an about 1 in 600 chance (according to the LA Times) of developing a brain tumor due to the radiation, which is equivalent of around 250 chest X-Rays. That's still a lot considering that approximately 150,000 people have the scan yearly (meaning that by the LA Times' figures, approximately 250 people will get brain cancer yearly from the procedure).

However, across the country there are reports popping up of the procedure going horribly wrong and exposing patients to much higher doses of radiation. The result has been that many patients have been reporting symptoms of radiation poisoning.

Reports first popped up at the Cedars-Sinai Medical Center in Los Angeles. The hospital informed some of its patients that they might have been exposed, but reportedly has been dragging its feet, not informing all its patients. Now the FDA has stepped in and is investigating the mess. The sad part is that some patients only found out about the potentially life-threatening mistake through news outlets.

One patient, Larry Biggles, says that the doctors willfully deceived him by never revealing the mistake. He recalls flaking skin, losing clumps of hair, headaches, and blurred vision. He recounts, "The word 'radiation' never came out of his mouth. He never said that we messed up and gave you an overdose of radiation."

Linda Morrow, a stroke victim, recalls similar irresponsibility. She states, "He said, 'Did you have any side effects, such as reddening of the skin or hair loss.' I said no. He said, 'Well, thank you very much,' and he hung up. "I thought: 'What the hell was that?'"

Since then, the FDA has discovered other cases of possible overdoses at Glendale Adventist Medical Center in Glendale, Calif. and Providence St. Joseph Medical Center in Burbank, Calif. and at Huntsville Hospital in Huntsville, Alabama. While the Cedars-Sinai Medical Center uses a General Electric perfusion scanner, St. Joseph uses a Toshiba model, adding an extra wrinkle to the puzzle.

According to early reports, it appears that both the Toshiba and GE scanners are configured to safe levels by technicians for the respective firms. Hospital technicians then proceeded to modify the protocols to satisfy doctors' requests for better resolution (more radiation yielded a better image). After patients began losing hair, the hospitals discovered their mistake, though none of them have officially admitted to making a "mistake".

In fact Dr. Barry D. Pressman, chairman of the imaging department at Cedars-Sinai, says that the delivered radiation was no greater than that during an angioplasty. Not only did the hospital do nothing wrong in his opinion, but they are looking to "address any side-effects that may occur, without unnecessarily alarming them." He comments, "I sincerely regret if any patient feels that they did not receive the information they needed."

Likewise, GE and Toshiba are unwilling to take the blame for not setting stricter limits on reconfiguring the scanner settings. Claims Arvind Gopalratnam, a spokesman for GE, "There were no malfunctions or defects in any of the GE Healthcare equipment involved."

Both the hospitals and the companies may face punishment from the FDA for their mistakes and tighter regulation -- whether or not they admit to them. A number of patients who suffered from unexpected radiation poisoning are also looking to sue the hospitals or scanner makers. In Alabama, Becky Coudert, a teacher in Madison County Schools, suffered from memory loss and hair loss after receiving a scan. She's now filed a class action suit against GE Healthcare in Alabama court. In total, the attorneys involved with the case report 15 other individuals may be added to the class. They are cooperating with attorneys in California who have over 200 patients looking to sue. Toshiba, which manufactured the St. Joseph Medical Center scanner, may also be targeted by this new suit.

This story is only beginning to come to light as the FDA says it expects there may be similar incidents found at other hospitals that practice perfusion scans.

As the litigation piles up, hospitals are facing the unpleasant decision of whether to absolve themselves of guilt or admit to wrongdoing and try to help the patients. Whatever their decision, hopefully the debacle will lead to tighter restrictions and more sensible administration across the country.

http://www.dailytech.com/Radiation+Over ... e17154.htm

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