The debate amongst doctors and medical professionals over the use of CT and MRI medical scanning continues, as Dr Raymond Damadian, the inventor of the first MR scanning machine weighs in.
The concerns of many doctors were voiced recently when former politician and doctor, Dr Arthur Chesterfield-Evans, released a report highlighting the risks of CT, or computed tomography, scans.
Dr Chesterfield-Evans cited a University of Melbourne study that found that a single CT scan on patients under 19 years of age increased the risk of any cancer by as much as 24 per cent.
“If the lifetime risk of cancer is one in five, and increases 24 per cent, it becomes one in four, which at a population level is highly significant,” he explained.
The study, led by Prof. John Mathews since 2004, postures that the relationship between atomic bomb radiation and brain cancer is dependent upon the age at exposure.
Dr Damadian appeared at the University of Western Sydney last week and cited the same article, explaining the alarming connection between the risk of cancer and radiation exposure, but did admit that genetics play a role in the rate of risk, particularly concerning Glioblastoma and Leukaemia.
Dr Damadian also highlighted the other benefits of MRI over CT imaging, including the efficacy of the MRI in catching strokes more than 90% more efficiently than CT scans, which is vital when it comes to the early intervention for the treatment of strokes. MRI scans also have a higher rate of positively diagnosing appendicitis, which can work to prevent the estimated 8,000 unnecessary appendectomies.
There is also a reduced risk to staff when a preference is given to MRIs over CT scans. Hospital staff are subject to stringent safety standards around CT scans, but exposure throughout a professional’s career can cause serious illness.
Dr Damadian explained that Australia has the highest density of CT machines per capita anywhere in the world, with 67 machines per million, and believes that preference needs to be given to MRI scans over CT scans.
Dr Chesterfield-Evans views align with Dr Damadian’s on this point, and believes that the government policy which privileges CT scanning over MRI is a contributing factor to Australia’s high death rate for cancer (exact figure is excluded here due to debate over “highest” death rate for cancer, as a figure cited by the doctor related to cancer cases, not death rates.)
While there is pressure to minimise CT use, particularly among children, the high rates of CT machines in Australia represent significant investments.
“When CT machines were introduced, the federal government licensed them, making them an investment being paid off by their use,” Dr Chesterfield-Evans writes.
“This created an incentive for more scans and scanners. It was a concise and expensive solution.
“When the MRI became freely available and proved itself to be a better and more sensitive modality for neuro, musculoskeletal and soft tissue organs, the government was not going to make the same financial mistake, so only allowed MRIs to be licensed in small numbers.
“CTs continue to dominate the radiological diagnostic practices since the 1990s, with seemingly little knowledge or concern about the consequent radiation doses to the population.”
Dr Chesterfield-Evans, a GP, explained that through the government restricting the use of MRI scans on Medicare but allowing CTs has meant more specialist appointments and higher income for the government.
“De-powering GPs has increased medical costs and unnecessarily irradiated the population.”
“Australia needs a concerted effort by governments to increase the number and variety of MRI machines and phase out CTs,” Dr Chesterfield-Evans advises.
Dr Damadian also explained the benefits of the MRI scans in terms of patient comfort, with no need for anaesthesia in children, as is necessary for small children. He also championed the MRI as the best response to trauma for emergency medicine for its ability to offer a high-resolution contrast image for the quickest diagnostic outcome.
Dr Damadian was in Sydney to discuss the history of the MRI machine as part of the launch of the University of Western Sydney’s Masters of Medical Imaging Course. Dr Damadian is largely considered to be the first inventor of the MR Scanning Machine. Initially interested in the way that sodium and potassium reacted to nuclear magnetic resonance, he grew his research base and initially constructed a magnetic resonance machine to test his findings.
From his research, he discovered that tumours responded differently to healthy tissue due to prolonged relaxation times of the cells under imaging, which was first used in 1977 to diagnose cancer successfully. From there, he created a full-body scanner to safely and accurately conduct high-contrast imaging on the human body, which became what is today known as the MRI machine.
While his work was once described as “visionary nonsense”, Dr Damadian has been the recipient of some of the world’s most prestigious awards, including the National Medal of Technology in 1998, an induction into the National Inventors Hall of Fame in 1989 and an Innovation Award in Bioscience from The Economist in 2003. While he was denied a Nobel prize for his invention due to controversy, many feel he should have been the recipient. His original full-body nuclear medical imaging machine is now on display at the Smithsonian Museum.