Despite increasing concerns about ionizing medical radiation and medical imaging, as well as numerous reports in the media over the last several years on the subject, a study in the journal Radiology has found that benefit/risk discussions about ionizing radiation from imaging are few and far between and seldom initiated by clinicians.

In this study researchers from Memorial Sloan Kettering Cancer Center in New York analyzed more than nine hours of conversations with 30 patients who underwent medical imaging to gauge their understanding of the benefits and risks of imaging, as well as their expectations regarding how those benefits and risks are communicated.

The participants were divided into six study groups—five groups of cancer patients and one group of participants in a lung-screening program. The researchers determined that the study subjects perceived that there were clear benefits from imaging examinations such as X-rays and CT scans, but that their knowledge varied about which exams used ionizing radiation.

For example, many patients were uncertain whether exams like mammography, bone scans and stress tests involved the use of ionizing radiation. Furthermore, many of the participants in the study didn’t know if MR imaging used ionizing radiation. In addition, some patients had difficulty distinguishing between radiation therapy and the ionizing radiation associated with diagnostic imaging

Many of the study participants were aware of the risks associated with ionizing radiation, but indicated a desire to get more information about specific test orders and intervals, as well as testing alternatives. And they want to get that information from their own doctors. They also expressed concerns that they had to initiate discussions about ionizing radiation.

"This may not be what we in the medical field want to hear, but I think it's important that we hear it," said senior author Jennifer Hay, PhD, a behavioral scientist at Memorial Sloan Kettering Cancer Center, in a release. "Patients want this information, and they prefer to receive it from doctors they know and trust."

The researchers also determined that patients were more eager for information about ionizing radiation as they progressed from the active cancer treatment to a post-treatment stage.

"Interest in having more information and participating in decision making about medical imaging clearly increased as patients transitioned from active cancer treatment to survivorship," said the study's lead author Raymond H. Thornton, MD., an interventional radiologist at Memorial Sloan Kettering Cancer Center. "Cancer survivors typically focus on healthful living and risk-factor reduction, so they were particularly eager to participate in discussions about potential long-term risks of radiation."