Self Assessment Module (SAM) Online: Patient Safety
Released: 9/4/2007 CME/SAM Expiration: 9/4/2010
This educational program is presented by the American College of Radiology and examines fundamental aspects of ionizing radiation hazards in the practice of CT through directed study of three publications. Brenner's publication in 2001 triggered a national re-assessment of CT for children and caused a substantial change in practice. The second and third publications place pediatric CT in the context of the overall problem of medical ionizing radiation exposures and the limitations of our knowledge of its biological effects.
The American College of Radiology designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™ and 1 SAM credit.
The American College of Radiology is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
This activity is qualified by the American Board of Radiology in meeting the criteria for self-assessment toward the purpose of fulfilling requirements in the ABR Maintenance of Certification Program.
Physicians should only claim credit commensurate with the extent of their participation in the activity.
Any competent radiologist should be aware of the basis for the change in practice and the assumptions and uncertainties associated with radiation risk assessments. This continuing medical education self-assessment module is intended for radiologists working toward the fulfillment of the ABR requirements for Maintenance of Certification in the General Content category of Patient Safety and Radiation Protection.
The participant in this activity will be able to:
- Quantify the difference in risk between adults and children for CT examinations.
- Explain the basis and sources of uncertainty of the risk estimate.
- Recommend appropriate modifications of practice to minimize risk while maintaining the medical benefit of the examination.
It is estimated that it will require 1.5 hours to read the material in this continuing medical education program and answer the self-assessment questions. After completing the reading, answer the post-test and survey questions. When you're finished, you will be able to print your CME and SAM certificates.
Step by step directions
1. Login and purchase the CME/SAM activity by clicking the Buy Now button.
2. Go to the My Education Page (reached via the ACR Campus) and launch the SAM Online activity.
3. Click the link to open and read each of the referenced articles [available in JACR or Online at this site.]
4. Complete 7 post-test questions about the reading material.
5. Claim CME/SAM credit
6. Optional opinion survey
7. Print your CME certificate
8. Print your SAM certificate
The faculty members listed below have indicated that they have no relevant financial relationships or conflicts of interest related to the presentation of their material.
John D Hazle PhD
Dept of Imaging Physics
UT MD Anderson Cancer Center
Charles Edward Willis PhD
Dept of Imaging Physics
UT MD Anderson Cancer Center
The ACR has received no commercial support for this activity.
The web-based CME activity requires a version 4.x web browser or newer and is best experienced using a current generation browser such as Internet Explorer 5.5/6.0 or newer. The required reading materials can be viewed using Adobe Acrobat Reader.
Click here to check if you have Adobe Acrobat Reader installed.
Tip: If popups are blocked, hold down the Control Key and then click the link.
More information about the software described above is available by following this link: Free Adobe Acrobat Reader.
Required Articles to Read
(To view the articles online, you need to have the Free Adobe Acrobat Reader. You can read the printed version in AJR February 2001)
Estimated Risks of Radiation-Induced Fatal Cancer from Pediatric CT by David J. Brenner1, Carl D. Elliston1, Eric J. Hall1 and Walter E. Berdon2
1 Center for Radiological Research, Columbia University, 630 W. 168th St., New York, NY 10032.
2 Department of Radiology, Division of Pediatric Radiology, Columbia-Presbyterian Medical Center, 630 W. 168th St., New York, NY 10032.
Objective. In light of the rapidly increasing frequency of pediatric CT examinations, the purpose of our study was to assess the lifetime cancer mortality risks attributable to radiation from pediatric CT. Conclusion. The best available risk estimates suggest that pediatric CT will result in significantly increased lifetime radiation risk over adult CT, both because of the increased dose per milliampere-second, and the increased lifetime risk per unit dose. Lower milliampere-second settings can be used for children without significant loss of information. Although the risk—benefit balance is still strongly tilted toward benefit, because the frequency of pediatric CT examinations is rapidly increasing, estimates that quantitative lifetime radiation risks for children undergoing CT are not negligible may stimulate more active reduction of CT exposure settings in pediatric patients.
Originally published in AJR February 2001, 176:289-296
Copyright © 2001 American Roentgen Ray Society - Used with permission.
Facts and Controversies About Radiation Exposure, Part 1: Controlling Unnecessary Radiation Exposures by
Jadwiga (Jodi) Strzelczyk, PhDa, John Damilakis, PhDb, M. Victoria Marx, MDc, Katarzyna J. Macura, MD, PhDd
(To view the articles online, you need to have the Free Adobe Acrobat Reader. You can read the printed version in JACR December 2006)
In this 2-part article, the authors address the need to put in perspective the risks of radiation exposure in the rapidly changing field of radiology, considering the current state of knowledge of effects at low levels. The article is based on the content of the refresher course RC 516 presented at the Radiological Society of North America’s 2005 annual meeting. After a brief review of epidemiologic studies, part 1 contains a discussion of typical radiation doses experienced in medicine, by both patients and professionals, and it concludes with a description of practical approaches to reduce unnecessary exposures.
Part 1 - Originally published in the JACR December 2006; Volume 3 number 12 pages 924-931 Copyright © 2006 American College of Radiology Used with permission.
Facts and Controversies About Radiation Exposure, Part 2: Low Level Exposures and Cancer Risk by Jadwiga (Jodi) Strzelczyk, PhDa, John Damilakis, PhDb, M. Victoria Marx, MDc, Katarzyna J. Macura, MD, PhDd
(To view the articles online, you need to have the Free Adobe Acrobat Reader. You can read the printed version in JACR January 2007 )
Part 2 of the article addresses a special concern for the unborn and discusses advisory and regulatory cancer risk estimates based mainly on epidemiologic studies. The limitations of epidemiologic studies at low-level exposures and recent new findings in radiobiology, some of which are summarized, challenge the notion that any amount of radiation causes adverse effects.
Part 2 - Originally published in the JACR January 2007; Volume 4 Number 1 pages 32-39 Copyright © 2007 American College of Radiology Used with permission.
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