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

Tue Apr 15 16:51:49 EDT 2025

It is the top-line story on AOL.com right now ...

On Tue, Apr 15, 2025 at 1:21 PM Olav Christianson via
Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list at lists.osu.edu> wrote:

> 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
> 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)
>>
>>
>>
>> *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*
>>
>> *https://urldefense.com/v3/__http://ow.ly/QfiB50ExGRi__;!!KGKeukY!2GgUJVr2IkNY4fV70UV6npqj_vnJLXS6D7pA3kAS986ojZ-LA0Pn6y3YvwuUc8EcQtvUes7t9mP_xkzJlgqjote6DLIl5-2tGTmPArwV$ 
>> <https://urldefense.com/v3/__http:/ow.ly/QfiB50ExGRi__;!!KGKeukY!33jASiIUrlVyKqW_HclMMl3N2Aadpgms7aIzZ_jkOczNeMvT0dA--hQLnKu7_ZBZDf2bGgyCpw7akegYlC3GiNPNVo8XZZ6Ex-kP3Qy3$>*
>>
>> *Zoom: https://urldefense.com/v3/__https://jhjhm.zoom.us/my/m.mahesh__;!!KGKeukY!2GgUJVr2IkNY4fV70UV6npqj_vnJLXS6D7pA3kAS986ojZ-LA0Pn6y3YvwuUc8EcQtvUes7t9mP_xkzJlgqjote6DLIl5-2tGSfiEs9G$ 
>> <https://urldefense.com/v3/__https:/jhjhm.zoom.us/my/m.mahesh__;!!KGKeukY!33jASiIUrlVyKqW_HclMMl3N2Aadpgms7aIzZ_jkOczNeMvT0dA--hQLnKu7_ZBZDf2bGgyCpw7akegYlC3GiNPNVo8XZZ6Ex0oLQ-DM$>*
>>
>>
>> =========================================================================================
>>
>>
>>
>> *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!2GgUJVr2IkNY4fV70UV6npqj_vnJLXS6D7pA3kAS986ojZ-LA0Pn6y3YvwuUc8EcQtvUes7t9mP_xkzJlgqjote6DLIl5-2tGSprzqel$ 
>> <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$>*
>>
>>  The work is entirely statistical in nature, there is no cohort study or
>> causal link found, just multiplying the presumed very small individual risk
>> of each CT scan times the tens of millions scans done each year. Please
>> read the article and be prepared to discuss it with colleagues, patients,
>> and physicians. A few key points to remember are:
>> 1. When ordered for medically indicated reasons the benefits of CT far
>> outweigh any future risk
>> 2. CT catches cancer earlier, changes and informs diagnosis, and can help
>> patients avoid unnecessary surgeries
>> 3. Research into radiation risk from low levels of ionizing radiation is
>> still a field of research and consensus on what the risk is has not been
>> reached
>> 4. Many CT scans are performed in the last years of patient's lives and
>> those CT scans can't contribute to future cancers (as the latency period
>> for most solid cancers is at least 4 years). The authors only excluded
>> scans that would have been performed in the last year of life from this
>> paper. A more realistic exclusion of 4 or 5 years would significantly
>> reduce the number of theoretical cancer inductions they claim.
>>
>>
>>
>> If you want to point folks to a reasonably balanced write up - I suggest
>> this one from Gizmodo (*https://urldefense.com/v3/__https://gizmodo.com/common-ct-scans-are-major-cancer-risk-study-claims-2000588963__;!!KGKeukY!2GgUJVr2IkNY4fV70UV6npqj_vnJLXS6D7pA3kAS986ojZ-LA0Pn6y3YvwuUc8EcQtvUes7t9mP_xkzJlgqjote6DLIl5-2tGYFPww8M$ 
>> <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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>>
>> <image005.png>
>>
>>
>>
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