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March 2, 2011

Informed Consent for Radiologic Procedures

JAMA. 2011;305(9):888-890. doi:10.1001/jama.2011.222

To the Editor: In their Commentary, Drs Baerlocher and Detsky endorsed discussing the radiation risks associated with computed tomography (CT) scans with patients through mandatory consent.1 Although discussion of risks is justifiable, obtaining signed, informed consent is problematic. First, the cancer risk is uncertain: it is small if present at all.24 While the American College of Radiology recommends that patients give signed, informed consent for radiologic procedures with a significant incidence of serious complications, the theoretical risk of a fatal cancer from a 10-mSv CT scan is only 0.05%.2 Moreover, the linear-no-threshold hypothesis for cancer risk from low-dose medical imaging has been debated for years,3 and the low but finite increased risk of cancer that was demonstrated in atomic bomb survivors has not been translated unequivocally to the risk from medical imaging.4

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