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Other Information Resources Related to Whole-Body CT Screening

This page contains a listing of links and other references that provide additional information related to computed tomography and the use of it for screening. Topics are listed under the following headings:

Readers are cautioned that many of these links are to sources of information external to the FDA web site and present information that has not been verified or endorsed by the FDA. Provision of such a link or information should not be considered an endorsement by the FDA or the Department of Health and Human Services of the information on these pages.

 General information

New England Journal of Medicine (NEJM) Article, November 29, 2007
"Computed Tomography (CT) - An Increasing Source of Radiation Exposure"
[Text] http://content.nejm.org/cgi/content/full/357/22/2277

Brochure: Full-Body CT Scans: What You Need to Know
[Text]
[PDF

A Dictionary of Cancer Terms from the National Cancer Institute.
http://www.cancer.gov/dictionary/

Information from the National Cancer Institute on Testing for Cancer.
http://www.cancer.gov/templates/list.aspx?viewid=9626735b-b689-43eb-b87e-e9f1bce323f4

A list of abbreviations related to CT from a web site specializing in CT evaluations.
http://www.impactscan.org/abbreviations.htm

A public information web site sponsored by the Radiological Society of North America and the American College of Radiology describing computed tomography of the body.
http://www.radiologyinfo.org/content/ct_of_the_body.htm

A general discussion of the diagnostic uses of CT, why it is used, how it works and what to expect during an examination.
http://www.imaginis.com/ct-scan/

A list of links to CT web sites.
http://www.auntminnie.com/index.asp?Sec=sup&Sub=cto&Pag=dis&ItemId=52003&d=1

Link to an introductory discussion of fundamental information regarding radiation and its effects.
http://www.uic.com.au/ral.htm

 Information on screening

Article from the FDA Consumer magazine (Nov.-Dec. 2001) describing whole-body CT scanning.
http://www.fda.gov/fdac/features/2001/601_ct.html

A recent opinion article in a leading radiology journal that raises concerns about the use of radiologic screening procedures in general.
http://www.ajronline.org/cgi/content/full/177/5/989

Article from the June 2001 issue of the American Journal of Roentgenology entitled "Ten Criteria for Effective Screening: Their Application to Multislice CT Screening for Pulmonary and Colorectal Cancer". This article describes ten criteria for an effective screening program in terms of the characteristics of the disease, the characteristics of the screening test and the treatments available if disease is found. http://www.ajronline.org/cgi/content/full/176/6/1357

An article describing the pros and cons of screening individuals without symptoms using CT.
http://www.insightmag.com/main.cfm?section_id=55534&include=section

An article from the American Medical Association's American Medical News (Sept. 3, 2001) discussing "Full-body scans: Buying peace of mind."
http://www.ama-assn.org/sci-pubs/amnews/pick_01/hlsa0903.htm

An article from the Harvard Health Letter (Nov. 2000) providing their perspective on whole-body screening.
http://www.health.harvard.edu/medline/Health/L1100f.html

Web site operated by the National Cancer Institute that provides general information on cancer and related issues.
http://cancer.gov/

The following section of the above web site provides a Cancer Screening Overview.
http://www.cancer.gov/templates/doc.aspx?viewid=6155397B-A57F-45BC-8898-4E5C290E0411

 Clinical studies

There are a number of studies that have been conducted or are underway to evaluate the effectiveness or benefit of the use of CT in screening for specific disease conditions in specific high-risk populations. Among these are studies of CT to screen for coronary artery disease, colon cancer, and lung cancer. Examples of these studies are the following that are being sponsored by the American College of Radiology Imaging Network:

Contemporary Screening for the Detection of Lung Cancer Pre-Malignancy and Malignancy.
http://www.acrin.org/protocols/6654/6654abstract.html

Computerized Tomographic Colonography: Performance Evaluation in a Multicenter Setting (Closed 10/17/00). 
http://www.acrin.org/PROTOCOLSUMMARYTABLE/PROTOCOL6656/tabid/146/Default.aspx

 Radiation risks

The National Council on Radiation Protection and Measurements (NCRP) is a nonprofit organization chartered by Congress that makes recommendations regarding protection against radiation. Several recent reports from the NCRP (http://www.ncrp.com) are relevant to the question of the risk from medical x-ray procedures.

NCRP Report No. 115, Risk Estimates for Radiation Protection (1993).

NCRP Report No. 126, Uncertainties in Fatal Cancer Risk Estimates Used in Radiation Protection (1997).

NCRP Report No. 136, Evaluation of the Linear-Nonthreshold Dose-Response Model for ionizing Radiation (2001).

The most recent evaluation of the effects of ionizing radiation by the National Academy of Sciences is given in the following publication:

Health Effects of Exposure to Low Levels of Ionizing Radiation BEIR V, Arthur C. Upton, et al. (Committee on the Biological Effects of Ionizing Radiations), National Academy Press, Washington, D.C. 1990 http://books.nap.edu/books/0309039959/html/index.html

The most recent report from the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) is contained in the following two volumes available from UNSCEAR.

SOURCES AND EFFECTS OF IONIZING RADIATION
United Nations Scientific Committee on the Effects of Atomic Radiation.
UNSCEAR 2000 Report to the General Assembly,
with scientific annexes Volume I: SOURCES.
http://www.unscear.org/2000vol1.htm

SOURCES AND EFFECTS OF IONIZING RADIATION
United Nations Scientific Committee on the Effects of Atomic Radiation.
UNSCEAR 2000 Report to the General Assembly,
with scientific annexes Volume II: EFFECTS.
http://www.unscear.org/2000vol2.htm

The most recent statement of the U. S. Government about estimating the risk from ionizing radiation is given in the following publication:

Marvin Rosenstein, et al. (CIRRPC Panel Report No. 9), Use of BEIR V and UNSCEAR 1988 in Radiation Risk Assessment. Lifetime Total Cancer Mortality and Risk Estimates at Low Doses and Low Dose Rates for Low-LET Radiation, Committee on Interagency Radiation Research and Policy Coordination, Office of Science and Technology Policy, Executive Office of the President, Washington, D.C, December 1992.

The following links describe recent results on the risk from ionizing radiation from the evaluation of data from the study of atomic bomb survivors from the Radiation Effects Research Foundation (RERF).

Radiation-related cancer risks at low doses among atomic bomb survivors. Pierce DA, Preston DL RERF Report No. 21-99 Radiation Research 154:178-86, 2000.
http://www.rerf.or.jp/eigo/rr/rr9921.htm

A brief summary article describing the results of the study
mentioned above is given at the following web site. See pages 15 - 17.
http://www.rerf.or.jp/eigo/update/01Spr-Sum.pdf

 Radiation dose from CT procedures

Information on typical radiation effective doses from diagnostic procedures.
European Commission, Radiation Protection Report 118, "Referral guidelines for imaging." Directorate-General for the Environment of the European Commission, 2000.
http://europa.eu.int/comm/environment/radprot/118/rp-118-en.pdf

Information on a recent publication from the European Coordination Committee of the Radiological and Electromedical Industries (COCIR) describing radiation exposure in computed tomography.
http://www.cocir.org/data/download/CTDoseBookabr.pdf

CT dose information from the ImPACT Group in the United Kingdom sponsored by the Medical Devices Agency.
http://www.impactscan.org/dosesurveysummary.htm
and
http://www.impactscan.org/ctdosimetry.htm
and
http://www.impactscan.org/slides/impactday/ctdosimetry/index.htm
and
http://www.impactscan.org/impactdayslides.htm#patdose

Discussion of dosimetry concepts used in computed tomography from a European Commission publication "EUROPEAN GUIDELINES ON QUALITY CRITERIA FOR COMPUTED TOMOGRAPHY."
http://www.drs.dk/guidelines/ct/quality/Page032.htm

Preliminary data from FDA's Nationwide Evaluation of X-Ray Trends (NEXT) 2000-01 Survey of Patient Radiation Exposure from Computed Tomographic (CT) Examinations in the United States.
PowerPoint

Final Results: Nationwide Evaluation of X-Ray Trends (NEXT) - Tabulation and Graphical Summary of 2000 Survey of Computed Tomography

Brochure: Radiation risks and Pediatric Computed Tomography (CT): A Guide for Health Care Providers

Public Health Notification: Reducing Radiation Risk from Computed Tomography for Pediatric and Small Adult Patients

 FDA's regulatory program for CT

Food, Drug, and Cosmetic Act

Performance standard for diagnostic x-ray systems
http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?FR=1020.30

Medical Device regulations

Premarket Notification 510(k) guidance document