[Intl_DxMedPhys] New JAMA IM article on CT radiation dose and future cancers

Tue Apr 15 14:20:28 EDT 2025

Hey everyone,

Thanks for sharing the JAMA Internal Medicine article and the great points
in response. I agree—it’s frustrating to see risk estimates presented
without much context, especially when they’re based purely on modeling and
not actual patient outcomes. It’s important we’re ready to address this
with our colleagues and patients.

I wanted to pass along a podcast episode that I think adds some helpful
perspective. Dr. Ehsan Samei recently appeared on the Frame by Frame
podcast and talked about radiation risk in imaging—but also why the usual
“risk vs. benefit” debate kind of misses the bigger picture.

He makes a strong case for focusing on the value of imaging when it’s used
appropriately, and how missing a diagnosis can often be far more harmful
than the very small theoretical risk we’re talking about.

You can find the episode here:

The Real Harm Is in Missing the Diagnosis' with Dr. Ehsan Samei

   - Frame by Frame <https://urldefense.com/v3/__https://framebyframe.life/e/4892k1mn-ehsan-samei-part1__;!!KGKeukY!3J1o5S6gGuzjlT6o_ML78yHpjNyJ5wYAt1WaTGOQeZG48IKe-C86u4cOempScgyia25FMp9Po1dHPqNqKkwu2ZF3EsCGCd1d3Cb28pzMk-vkqWnM$ >
   - Apple Podcasts
   <https://urldefense.com/v3/__https://podcasts.apple.com/us/podcast/the-real-harm-is-in-missing-the-diagnosis-with-dr-ehsan-samei/id1768991734?i=1000702062470__;!!KGKeukY!3J1o5S6gGuzjlT6o_ML78yHpjNyJ5wYAt1WaTGOQeZG48IKe-C86u4cOempScgyia25FMp9Po1dHPqNqKkwu2ZF3EsCGCd1d3Cb28pzMk6vSPq6D$ >
   - Spotify <https://urldefense.com/v3/__https://open.spotify.com/episode/6rFJk7UWZSLIVmBI5qynX9__;!!KGKeukY!3J1o5S6gGuzjlT6o_ML78yHpjNyJ5wYAt1WaTGOQeZG48IKe-C86u4cOempScgyia25FMp9Po1dHPqNqKkwu2ZF3EsCGCd1d3Cb28pzMkxRVedqj$ >

Best,

Olav

On Tue, Apr 15, 2025 at 11:13 AM Dr M. Mahesh via
Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list at lists.osu.edu> wrote:

> You are welcome. We are trying to do our best to pushback on these types
> of studies which only u creases fear in general public and may lead to few
> patients denying the needed CT. As we said, the efforts done for the past
> two decades are yielding
> You are welcome. We are trying to do our best to pushback on these types
> of studies which only u creases fear in general public and may lead to few
> patients denying the needed CT. As we said, the efforts done for the past
> two decades are yielding much lower doses per CT. Thanks to technological
> advances, role of medical physicists in the dose optimization etc
>
> Mahesh
>
> *Be Curious!*
>
>
> “Please do not feel obligated to respond after normal working hours”
>
> *=================================================================*
>
> *M. Mahesh, MS, PhD, FAAPM, FACR, FACMP, FSCCT, FIOMP.*
>
> Professor - The Russell H. Morgan Department of Radiology and Radiological
> Science
>
>
> *President - American Association of Physicists in Medicine *
>
>
> JHOC, Suite 4264
>
> 601 N Caroline Street,
>
> Baltimore, MD 21287-0856
>
> (410)  <(410)%C2%A0955-5115>955-5115 <(410)%C2%A0955-5115> (O)
>
> (410) 404-8742 (M)
>
> *================================================================*
>
> On Apr 15, 2025, at 11:08 AM, Matt Wait <Matt.Wait at kp.org> wrote:
>
> 
>
>
> *      External Email - Use Caution      *
>
>
>
> I am grateful that AAPM has been able to respond so swiftly, along with
> ACR.
>
>
>
> *Matt Wait, MS, DABR, DABSNM, MRSE*
> Senior Diagnostic Physicist
>
> Assistant Radiation Safety Officer
>
> Assistant Residency Director
>
> *Kaiser Permanente*
>
> *Southern Permanente Medical Group*
> Medical Imaging Technology and Informatics
> 4867 Sunset Blvd
>
> Los Angeles, CA 90027
>
> x5347 (office)
>
> (818) 232-2427 (mobile phone)
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>
>
> *From:* Intl_dxmedphys_wd_osu_list <
> intl_dxmedphys_wd_osu_list-bounces at lists.osu.edu> *On Behalf Of *Dr M.
> Mahesh via Intl_dxmedphys_wd_osu_list
> *Sent:* Tuesday, April 15, 2025 7:10 AM
> *To:* intl_dxmedphys_wd_osu_list at lists.osu.edu
> *Subject:* Re: [Intl_DxMedPhys] New JAMA IM article on CT radiation dose
> and future cancers
>
>
>
> Please see attached the AAPM Press release regarding the JAMA publication.
> This will be on the AAPM website under Press Release later today. Mahesh Be
> Curious! Please do not feel obligated to respond after normal working
> hours!
> ==========================================================================================
>
> *Caution: *This email came from outside Kaiser Permanente. Do not open
> attachments or click on links if you do not recognize the sender.
> ------------------------------
>
> Please see attached the AAPM Press release regarding the JAMA publication.
>
>
>
> This will be on the AAPM website under Press Release later today.
>
>
>
> Mahesh
>
>
>
> *Be Curious!*
>
> Please do not feel obligated to respond after normal working hours!
>
> <image003.png>
> <image004.png>
>
>
> ==========================================================================================
>
> *M. Mahesh, MS, PhD, FAAPM, FACR, FACMP, FSCCT, FIOMP.*
>
> *(he/him/his)*
>
> *Professor -* The Russell H. Morgan Department of Radiology and
> Radiological Science
>
> Johns Hopkins University School of Medicine
>
> *Chair* – Radiation Control Committee, Johns Hopkins Health Systems
>
>
>
> *President, American Association of Physicists in Medicine (AAPM*)
>
>
>
> 601 N Caroline Street,
>
> Baltimore, MD 21287-0856
>
> *(410) 955-5115 <(410)%C2%A0955-5115>* (O)
>
> (410) 404-8742 (M)
>
> *BlueSky: **@mmahesh.bsky.social*
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> =========================================================================================
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>
>
> *From: *Intl_dxmedphys_wd_osu_list <
> intl_dxmedphys_wd_osu_list-bounces+mmahesh=jhmi.edu at lists.osu.edu> on
> behalf of Robert Morrison via Intl_dxmedphys_wd_osu_list <
> intl_dxmedphys_wd_osu_list at lists.osu.edu>
> *Date: *Tuesday, April 15, 2025 at 9:25 AM
> *To: *Robert Walker <badgerpet at gmail.com>, Yang, Kai,PhD <
> KYANG11 at mgh.harvard.edu>
> *Cc: *intl_dxmedphys_wd_osu_list at lists.osu.edu <
> intl_dxmedphys_wd_osu_list at lists.osu.edu>
> *Subject: *Re: [Intl_DxMedPhys] New JAMA IM article on CT radiation dose
> and future cancers
>
>
> *      External Email - Use Caution      *
>
>
>
>
>
> The use of sensationalism and fear tactics is nothing new.  We see it
> continually used.  The whole Covid debacle is one case in point.  There is
> a power that we/people get from these types of things. I sent Mark's post
> on to a bunch of people yesterday so that they would be inoculated from
> this type of thing.  I guess we will see how this plays out.
>
>
>
> Rob Morrison
> ------------------------------
>
> *From:* Intl_dxmedphys_wd_osu_list on behalf of Yang, Kai, PhD via
> Intl_dxmedphys_wd_osu_list
> *Sent:* Tuesday, April 15, 2025 08:36
> *To:* Robert Walker
> *Cc:* intl_dxmedphys_wd_osu_list at lists.osu.edu
> *Subject:* Re: [Intl_DxMedPhys] New JAMA IM article on CT radiation dose
> and future cancers
>
>
>
> Unfortunately, I just heard this information as a breaking news from our
> local radio station in my car this morning. Cannot imagine how much more
> fear they are creating for every patients.
>
>
>
> *From:* Intl_dxmedphys_wd_osu_list <
> intl_dxmedphys_wd_osu_list-bounces at lists.osu.edu> *On Behalf Of *Robert
> Walker via Intl_dxmedphys_wd_osu_list
> *Sent:* Monday, April 14, 2025 8:52 PM
> *Cc:* intl_dxmedphys_wd_osu_list at lists.osu.edu
> *Subject:* Re: [Intl_DxMedPhys] New JAMA IM article on CT radiation dose
> and future cancers
>
>
>
> *        External Email - Use Caution        *
>
> Thanks for going on the record Mark. In case you missed it, the lead
> author is also a cofounder of Alara Imaging, the steward of the CT
> radiation dose CMS measure. On Mon, Apr 14, 2025 at 8: 29 AM Mark
> Supanich via Intl_dxmedphys_wd_osu_list
>
> Thanks for going on the record Mark.
>
>
>
> In case you missed it, the lead author is also a cofounder of Alara
> Imaging, the steward of the CT radiation dose CMS measure.
>
>
>
>
>
> On Mon, Apr 14, 2025 at 8:29 AM Mark Supanich via
> Intl_dxmedphys_wd_osu_list <*intl_dxmedphys_wd_osu_list at lists.osu.edu
> <intl_dxmedphys_wd_osu_list at lists.osu.edu>*> wrote:
>
> There's a new article in JAMA internal medicine out predicting a large
> number of future cancers from CT scans. https: //jamanetwork. com/journals/jamainternalmedicine/fullarticle/2832778
> The work is entirely statistical in nature, there is no
>
> There's a new article in JAMA internal medicine out predicting a large
> number of future cancers from CT scans. *https://urldefense.com/v3/__https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2832778__;!!KGKeukY!3J1o5S6gGuzjlT6o_ML78yHpjNyJ5wYAt1WaTGOQeZG48IKe-C86u4cOempScgyia25FMp9Po1dHPqNqKkwu2ZF3EsCGCd1d3Cb28pzMky6J7jgk$ 
> <https://urldefense.com/v3/__https:/secure-web.cisco.com/11c3R7RDCXdOZJAeh-qRdh8RQoy4MIyh-bGKSdYXybKeZeTkvWPCE5cxAVfLiLi0Q2PdKvJolVd8bPwhP3i3nBclYsE_nDLEajdXuRzgjQx9D3NDBU9qufW-DqJI_iU7MvY5L-6euVAPjcz5n6L59StkH6la9egu2M3QYHtegAOfn9_cv9Fr8_h7IalxNPkzALjSfai-BOTNJkjp6oMrcTo7QloFQ01N8iFgsvCHCpxxAhUDOriwE1RmRd4IyhFVjlxA4iKdyZPmqF6OlPh3kifG5QJuaT1X5ECZ8RxP2q4HlbJM6TLcotu4jbem_QNdhKncgqi37ETvCZwngIgqaQw/https*3A*2F*2Furldefense.com*2Fv3*2F__https*3A*2F*2Fjamanetwork.com*2Fjournals*2Fjamainternalmedicine*2Ffullarticle*2F2832778__*3B*21*21KGKeukY*213QiV5I4K5v5DkFeVCQcvqSvpeu1GCW4Xu2kfC-OIisjve02FMcil1jtQ4DKwavLox_91CTk9e1T7WF2R_hfH5GcmWjHVWZJE1htAOpCHDAyPO8c*24__;JSUlJSUlJSUlJSUlJSUlJSU!!KGKeukY!1Reaf_Fky05djN-QBH_RvPNHirWnP17iZGrZc8CdlACOX8map7-euQP6fldftfkSgFYl77xI8nXbDT7PoYly8kxaGJV7khHYGBxQmQCgqgfbcQ$>*
>
>  The work is entirely statistical in nature, there is no cohort study or
> causal link found, just multiplying the presumed very small individual risk
> of each CT scan times the tens of millions scans done each year. Please
> read the article and be prepared to discuss it with colleagues, patients,
> and physicians. A few key points to remember are:
> 1. When ordered for medically indicated reasons the benefits of CT far
> outweigh any future risk
> 2. CT catches cancer earlier, changes and informs diagnosis, and can help
> patients avoid unnecessary surgeries
> 3. Research into radiation risk from low levels of ionizing radiation is
> still a field of research and consensus on what the risk is has not been
> reached
> 4. Many CT scans are performed in the last years of patient's lives and
> those CT scans can't contribute to future cancers (as the latency period
> for most solid cancers is at least 4 years). The authors only excluded
> scans that would have been performed in the last year of life from this
> paper. A more realistic exclusion of 4 or 5 years would significantly
> reduce the number of theoretical cancer inductions they claim.
>
>
>
> If you want to point folks to a reasonably balanced write up - I suggest
> this one from Gizmodo (*https://urldefense.com/v3/__https://gizmodo.com/common-ct-scans-are-major-cancer-risk-study-claims-2000588963__;!!KGKeukY!3J1o5S6gGuzjlT6o_ML78yHpjNyJ5wYAt1WaTGOQeZG48IKe-C86u4cOempScgyia25FMp9Po1dHPqNqKkwu2ZF3EsCGCd1d3Cb28pzMk4wLc8dz$ 
> <https://urldefense.com/v3/__https:/secure-web.cisco.com/1wrV2WSfGaAaDNVWZIuE4w8B43lrQ3or0vqj-dCCs2cwV5kEL96Yrhp5c5pA9RycHBx7s2_48xiYuL7jSRebxiV_NKbCW4Z557Jvsuf_fNBx916U8vjc3iZtMt1uORMsjtbuYW6ke-jHUVQYLIOcpyy1FaM-cEbUd5xgkQlw8bPY39JUd7LfvIKmw06cchseq7DmlPAhxFuRzT6RudnkO8vUKhZPcyW5Km57eyA6pl8oVLJIN5RnJfvu2HfmJVqLNlO2maVvvndX0YQAPeU3X9mcI0ggaEpRyz8AosJ8ZNH5O7deNXt6iS1FObjj4Vmu0jqX47lxq4U_tESMMJ-lO3Q/https*3A*2F*2Furldefense.com*2Fv3*2F__https*3A*2F*2Fgizmodo.com*2Fcommon-ct-scans-are-major-cancer-risk-study-claims-2000588963__*3B*21*21KGKeukY*213QiV5I4K5v5DkFeVCQcvqSvpeu1GCW4Xu2kfC-OIisjve02FMcil1jtQ4DKwavLox_91CTk9e1T7WF2R_hfH5GcmWjHVWZJE1htAOpCHBbVsiPc*24__;JSUlJSUlJSUlJSUlJSU!!KGKeukY!1Reaf_Fky05djN-QBH_RvPNHirWnP17iZGrZc8CdlACOX8map7-euQP6fldftfkSgFYl77xI8nXbDT7PoYly8kxaGJV7khHYGBxQmQCuBbjgyg$>*).
> The author reached out for outside comment in advance of publication, and I
> am grateful that he did, as I was able to (with help from Cynthia
> McCollough and Rebecca Milman) provide some additional context and
> critiques.
>
>
>
>
>
>
>
> --
>
> *Mark P. Supanich, Ph.D., DABR, FAAPM* (he/him)
>
> Director – Diagnostic Medical Physics
>
> Rush University System for Health
>
> Associate Professor & Vice Chair for Physics and Informatics
>
> Rush Medical College Department of Diagnostic Radiology and Nuclear
> Medicine
>
> O: 312.563.4552
>
> *Book time with Mark Supanich
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