When referring a patient for imaging, consider the benefits and harms of each type of imaging to determine which is the most appropriate. These include:
- the specific needs of the investigation
- the patient’s ionising radiation dose
- management of any incidental finding
- the consequences of overdiagnosis.
Consider which imaging modality is best for answering the specific clinical question and minimising the risk of harms.
For example, if a CT scan of an organ is being considered, balance the benefits of enhanced image quality of a CT scan against the risk of harms associated with the ionising radiation, compared to an ultrasound, which does not contain any ionising radiation.3
Although X-rays are rarely indicated for investigating chronic abdominal pain,4 they are associated with much lower doses of ionising radiation than CT scans and so should be considered where appropriate.5
For example, the ionising radiation dose from an abdominal X-ray of the stomach is at least 50 times smaller than the dose from an abdominal CT scan.5
Find out more about managing the risk of exposing patients to ionising radiation
Increased use of modalities associated with high imaging quality such as CT scans increases the risk of incidental findings.6
The American College of Radiography provides information about incidental findings
This information is available to help radiologists make informed decisions when reporting on imaging tests and also to help medical practitioners manage incidental findings.
Overdiagnosis is a harmful and costly problem with two major causes: overdetection and overdefinition of disease. While the forms of overdiagnosis differ, the consequences are the same: diagnoses that ultimately cause more harm than benefit.6