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

Fri Apr 18 13:19:24 EDT 2025

This has made it to national television news.  (I heard the "parroting" of
the study and results on XM this morning, by a television network to which
I happened to be listening.  I will wager that all the other major networks
have or will also "parrot".)

On Tue, Apr 15, 2025 at 4:49 PM Jerry Thomas via Intl_dxmedphys_wd_osu_list
<intl_dxmedphys_wd_osu_list at lists.osu.edu> wrote:

> This message was sent securely using Zix® Nima, Dr. Rebeccs Smith-Bindman
> is a power to be reckoned with. She is a very impressive person with a
> great deal of influence at UCSF as well as within the HHS. She is a
> prolific grantsman with
> This message was sent securely using Zix®
> <https://urldefense.com/v3/__http://www.zixcorp.com/get-started/__;!!KGKeukY!ytVHnFXwh22ca4utaKvv_GHtIPB8KERiTOykmfmORhbNvS3xFymqS1o5FJLVkAhHXqmee8XBF0k45K8i8z8OCQlMHEZlNwHCM1kh-s1VAdDPDtU$>
> Nima,
>
>     Dr. Rebeccs Smith-Bindman is a power to be reckoned with.  She is a
> very impressive person with a great deal of influence at UCSF as well as
> within the HHS.  She is a prolific grantsman with over 134 peer-reviewed
> papers.  Go to this UCSF site for more detail on her position and work:
> https://urldefense.com/v3/__https://cancer.ucsf.edu/people/smith-bindman.rebecca__;!!KGKeukY!xYcoERUqLAdCe9MERlXWDkZ9SOIfx1vOpBGHuhhLE-ICV91IgVeje9d2e4sVJueqK7FixWIZ3de1INJmIr2woqjxLBaE8NSGRQ6aTv5H$ 
> <https://urldefense.com/v3/__https://cancer.ucsf.edu/people/smith-bindman.rebecca__;!!KGKeukY!ytVHnFXwh22ca4utaKvv_GHtIPB8KERiTOykmfmORhbNvS3xFymqS1o5FJLVkAhHXqmee8XBF0k45K8i8z8OCQlMHEZlNwHCM1kh-s1VKYdXteI$>.
> She completed her Radiology residency at UCSF in 1996 and followed up with
> a fellowship in Epidemiology and Biostatistics at UCSF in 1998.
>
>     In Sep 2023 (7-9) she hosted a virtual conference "Everything you need
> to know about CT:  Maximizing Quality and Safety".  I have attached the
> meeting agenda.  That meeting was a clear outline of her long-term
> objectives to "control / eliminate" CT dose -- the end objective of this
> conference seemed to be zero CT dose -- e.g. eliminate CT from the practice
> of medicine.  Many of the papers presented were without scientific merit
> and were biased toward the work being done by ALARA, Inc.
>
>      The horse may be out of the barn and it may be too late to modify
> and/or stop the inertia and political clout she has in this area.  The ACR
> and AAPM statements on the JAMA paper will most likely have little to no
> impact on the momentum she has generated nor on her company ALARA, Inc or
> on the CMS mandate.  It is unfortunate; but this may be a modern day Herman
> Mueller (LNT came from his work) when it comes to the long-term impact of
> her work.  Unfortunately, the negative impact her work is having on the use
> of CT and the public's understanding of its relation to cancer induction
> vs. the diagnostic benefit will be substantial.  Unless ACR, AAPM, HPS and
> other scientific / medical based organizations can get the ear of HHS
> leadership we may be stuck in a down-ward spiral.  To be a bit pessimistic,
> I doubt that "good science" will win on this issue.
>
> Jerry
>
>
> Jerry Thomas, MS, FAAPM, DABR, CHP, DABSNM
> Diagnostic Medical Physicist / Radiation Safety Officer
> Ascension Via Christi Hospitals Wichita
> Wichita, KS  67214
>
> Phone:  316-268-5958  (office)
>             240-447-1014  (cell)
>
>
> On Tue, Apr 15, 2025 at 2:10 PM Nima Kasraie via
> Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list at lists.osu.edu>
> wrote:
>
>> Silly suggestion: If this author is the same author that has been writing
>> high-profile radio-phobic articles for +10 yrs now, would it not be a good
>> idea maybe to sit down and perhaps open a channel of conversation with
>> them? Otherwise from
>>
>> Silly suggestion: If this author is the same author that has been writing
>> high-profile radio-phobic articles for +10 yrs now, would it not be a good
>> idea maybe to sit down and perhaps open a channel of conversation with
>> them?
>>
>>
>>
>> Otherwise from the laymen (non-expert) perspective, this will end up
>> being a ‘our word vs. their word’ type of scenario, again. Truth and facts
>> have (unfortunately) become subjective nowadays. So who does one choose to
>> believe? A renowned Radiologist, or a physicist (that might have an alleged
>> interest in trying to “sell” radiation)?
>>
>>
>>
>> All I’m saying is, this back and forth has been going on a for a while.
>>
>>
>>
>>
>>
>>
>>
>> Nima
>>
>>
>>
>>
>>
>>
>>
>> P.S: “Are you trying to sell Radiation to the public?” is EXACTLY what I
>> was told by a PEDIATRIC RADIOLOGY manuscript reviewer a few years ago. (in
>> response to a mere benefit-to-risk ratio verbiage I had in my draft).
>>
>>
>>
>>
>>
>>
>>
>>
>>
>>
>>
>> *Nima Kasraie, PhD, MSc, DABR, DABSNM *
>>
>> Lead Physicist, Children’s Medical Center Dallas
>> <https://urldefense.com/v3/__https://www.childrens.com/__;!!KGKeukY!xzJ0kMP0axSIjBblGK0JrWaDtn1cXl9vAjSGQksnuV6J6YSoH2Ru6gGnC19yFEM3iO35rlA0RYHUwl71YYxrO67-unaOAf2XyhPySc4zUq2b9_gk9acN2w$>
>>
>> Associate Professor, Department of Radiology, UT Southwestern
>> <https://urldefense.com/v3/__https://profiles.utsouthwestern.edu/profile/187443/nima-kasraie.html__;!!KGKeukY!xzJ0kMP0axSIjBblGK0JrWaDtn1cXl9vAjSGQksnuV6J6YSoH2Ru6gGnC19yFEM3iO35rlA0RYHUwl71YYxrO67-unaOAf2XyhPySc4zUq2b9_jq9hvz9A$>
>>
>> Phone: 214-648-7978
>>
>>
>>
>> *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 9:10 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!
>> ==========================================================================================
>>
>> 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!
>> ==========================================================================================
>>
>> 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!
>>
>> [image: Screenshot 2025-04-15 at 10.09.46 AM.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!xYcoERUqLAdCe9MERlXWDkZ9SOIfx1vOpBGHuhhLE-ICV91IgVeje9d2e4sVJueqK7FixWIZ3de1INJmIr2woqjxLBaE8NSGRQO9apr5$ 
>> <https://urldefense.com/v3/__http:/ow.ly/QfiB50ExGRi__;!!KGKeukY!33jASiIUrlVyKqW_HclMMl3N2Aadpgms7aIzZ_jkOczNeMvT0dA--hQLnKu7_ZBZDf2bGgyCpw7akegYlC3GiNPNVo8XZZ6Ex-kP3Qy3$>*
>>
>> *Zoom: https://urldefense.com/v3/__https://jhjhm.zoom.us/my/m.mahesh__;!!KGKeukY!xYcoERUqLAdCe9MERlXWDkZ9SOIfx1vOpBGHuhhLE-ICV91IgVeje9d2e4sVJueqK7FixWIZ3de1INJmIr2woqjxLBaE8NSGRT32Pflf$ 
>> <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!xYcoERUqLAdCe9MERlXWDkZ9SOIfx1vOpBGHuhhLE-ICV91IgVeje9d2e4sVJueqK7FixWIZ3de1INJmIr2woqjxLBaE8NSGRQupgg2N$ 
>> <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$>*
>>
>>  The work is entirely statistical in nature, there is no cohort study or
>> causal link found, just multiplying the presumed very small individual risk
>> of each CT scan times the tens of millions scans done each year. Please
>> read the article and be prepared to discuss it with colleagues, patients,
>> and physicians. A few key points to remember are:
>> 1. When ordered for medically indicated reasons the benefits of CT far
>> outweigh any future risk
>> 2. CT catches cancer earlier, changes and informs diagnosis, and can help
>> patients avoid unnecessary surgeries
>> 3. Research into radiation risk from low levels of ionizing radiation is
>> still a field of research and consensus on what the risk is has not been
>> reached
>> 4. Many CT scans are performed in the last years of patient's lives and
>> those CT scans can't contribute to future cancers (as the latency period
>> for most solid cancers is at least 4 years). The authors only excluded
>> scans that would have been performed in the last year of life from this
>> paper. A more realistic exclusion of 4 or 5 years would significantly
>> reduce the number of theoretical cancer inductions they claim.
>>
>>
>>
>> If you want to point folks to a reasonably balanced write up - I suggest
>> this one from Gizmodo (*https://urldefense.com/v3/__https://gizmodo.com/common-ct-scans-are-major-cancer-risk-study-claims-2000588963__;!!KGKeukY!xYcoERUqLAdCe9MERlXWDkZ9SOIfx1vOpBGHuhhLE-ICV91IgVeje9d2e4sVJueqK7FixWIZ3de1INJmIr2woqjxLBaE8NSGRevqWfU6$ 
>> <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$>*).
>> The author reached out for outside comment in advance of publication, and I
>> am grateful that he did, as I was able to (with help from Cynthia
>> McCollough and Rebecca Milman) provide some additional context and
>> critiques.
>>
>>
>>
>>
>>
>>
>>
>> --
>>
>> *Mark P. Supanich, Ph.D., DABR, FAAPM* (he/him)
>>
>> Director – Diagnostic Medical Physics
>>
>> Rush University System for Health
>>
>> Associate Professor & Vice Chair for Physics and Informatics
>>
>> Rush Medical College Department of Diagnostic Radiology and Nuclear
>> Medicine
>>
>> O: 312.563.4552
>>
>> *Book time with Mark Supanich
>> <https://urldefense.com/v3/__https:/secure-web.cisco.com/1vUCBELtnWBv8xSrzt5lj7RLVcKkezmy7bFD4cV2flVIpgIpgpNXKuOFjnMO9PUirpGvbDpSh-INwqYD82VrQWIaaRRk5wOvjotSUSqZjY6eUFfbIcWP0W-9-xac9Uc6hAxJDyUj73jpTp-KxgjjzpBeGTdsyPvHzjg6zp3idfZQ0m8igESIXLbny-JiNfSqEqXZLhRpiIwm1WKS0rGLYuAR613wjsWFMyoGgyzHWAFXHudzxJCtNdTqFzNFSKOHmHG9Bsp6QZGbN1xrLk-J3PIbLS6HrJSRLPlnLYvUhSutX1JpNEwwdUCPjdT5SnHs9OD7i-ywg3TRzz89BtDqlLA/https*3A*2F*2Furldefense.com*2Fv3*2F__https*3A*2F*2Foutlook.office.com*2Fbookwithme*2Fuser*2F359cac7eb98843cab54ba1332197fc80*40rush.edu*3Fanonymous*26ep*3Dpcard__*3B*21*21KGKeukY*213QiV5I4K5v5DkFeVCQcvqSvpeu1GCW4Xu2kfC-OIisjve02FMcil1jtQ4DKwavLox_91CTk9e1T7WF2R_hfH5GcmWjHVWZJE1htAOpCHDsvvcb4*24__;JSUlJSUlJSUlJSUlJSUlJSUlJSU!!KGKeukY!1Reaf_Fky05djN-QBH_RvPNHirWnP17iZGrZc8CdlACOX8map7-euQP6fldftfkSgFYl77xI8nXbDT7PoYly8kxaGJV7khHYGBxQmQBPTFfVCA$>*
>>
>> [image: RUSH]
>>
>>
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