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Mettler FA, Mahesh M, Bhargavan-Chatfield M, Chambers CE, Elee JG, Frush DP, Miller DL, Royal HD, Milano MT, Spelic DC, Ansari AJ, Bolch WE, Guebert GM, Sherrier RH, Smith JM, Vetter RJ. Patient Exposure from Radiologic and Nuclear Medicine Procedures in the United States: Procedure Volume and Effective Dose for the Period 2006-2016. Radiology 2020; 295:418-427. [PMID: 32181730 DOI: 10.1148/radiol.2020192256] [Citation(s) in RCA: 128] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background Comprehensive assessments of the frequency and associated doses from radiologic and nuclear medicine procedures are rarely conducted. The use of these procedures and the population-based radiation dose increased remarkably from 1980 to 2006. Purpose To determine the change in per capita radiation exposure in the United States from 2006 to 2016. Materials and Methods The U.S. National Council on Radiation Protection and Measurements conducted a retrospective assessment for 2016 and compared the results to previously published data for the year 2006. Effective dose values for procedures were obtained from the literature, and frequency data were obtained from commercial, governmental, and professional society data. Results In the United States in 2006, an estimated 377 million diagnostic and interventional radiologic examinations were performed. This value remained essentially the same for 2016 even though the U.S. population had increased by about 24 million people. The number of CT scans performed increased from 67 million to 84 million, but the number of other procedures (eg, diagnostic fluoroscopy) and nuclear medicine procedures decreased from 17 million to 13.5 million. The number of dental radiographic and dental CT examinations performed was estimated to be about 320 million in 2016. Using the tissue-weighting factors from Publication 60 of the International Commission on Radiological Protection, the U.S. annual individual (per capita) effective dose from diagnostic and interventional medical procedures was estimated to have been 2.9 mSv in 2006 and 2.3 mSv in 2016, with the collective doses being 885 000 and 755 000 person-sievert, respectively. Conclusion The trend from 1980 to 2006 of increasing dose from medical radiation has reversed. Estimated 2016 total collective effective dose and radiation dose per capita dose are lower than in 2006. © RSNA, 2020 See also the editorial by Einstein in this issue.
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Affiliation(s)
- Fred A Mettler
- From the Department of Radiology, University of New Mexico, 3004 La Mancha Dr NW, Albuquerque, NM 87104 (F.A.M.); Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Md (M.M.); Department for Quality and Safety, American College of Radiology, Reston, Va (M.B.C.); Departments of Radiology and Medicine, Penn State Hershey Medical Center, Hershey, Pa (C.E.C.); Radiation Section, Louisiana Department of Environmental Quality, West Monroe, La (J.G.E.); Department of Radiology, Stanford University, Stanford, Calif (D.P.F.); Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M., D.C.S.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (H.D.R.); Department of Radiation Oncology, University of Rochester, Rochester, NY (M.T.M.); Radiation Studies Section, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Ga (A.J.A.); Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Fla (W.E.B.); Department of Radiology, Logan University, Maryland Heights, Mo (G.M.G.); Duke University, U.S. Department of Veterans Affairs, Durham, NC (R.H.S.); Rollins School of Public Health, Emory University, Atlanta, Ga (J.M.S.); and Mayo Clinic, Rochester, Minn (R.J.V.)
| | - Mahadevappa Mahesh
- From the Department of Radiology, University of New Mexico, 3004 La Mancha Dr NW, Albuquerque, NM 87104 (F.A.M.); Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Md (M.M.); Department for Quality and Safety, American College of Radiology, Reston, Va (M.B.C.); Departments of Radiology and Medicine, Penn State Hershey Medical Center, Hershey, Pa (C.E.C.); Radiation Section, Louisiana Department of Environmental Quality, West Monroe, La (J.G.E.); Department of Radiology, Stanford University, Stanford, Calif (D.P.F.); Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M., D.C.S.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (H.D.R.); Department of Radiation Oncology, University of Rochester, Rochester, NY (M.T.M.); Radiation Studies Section, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Ga (A.J.A.); Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Fla (W.E.B.); Department of Radiology, Logan University, Maryland Heights, Mo (G.M.G.); Duke University, U.S. Department of Veterans Affairs, Durham, NC (R.H.S.); Rollins School of Public Health, Emory University, Atlanta, Ga (J.M.S.); and Mayo Clinic, Rochester, Minn (R.J.V.)
| | - Mythreyi Bhargavan-Chatfield
- From the Department of Radiology, University of New Mexico, 3004 La Mancha Dr NW, Albuquerque, NM 87104 (F.A.M.); Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Md (M.M.); Department for Quality and Safety, American College of Radiology, Reston, Va (M.B.C.); Departments of Radiology and Medicine, Penn State Hershey Medical Center, Hershey, Pa (C.E.C.); Radiation Section, Louisiana Department of Environmental Quality, West Monroe, La (J.G.E.); Department of Radiology, Stanford University, Stanford, Calif (D.P.F.); Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M., D.C.S.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (H.D.R.); Department of Radiation Oncology, University of Rochester, Rochester, NY (M.T.M.); Radiation Studies Section, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Ga (A.J.A.); Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Fla (W.E.B.); Department of Radiology, Logan University, Maryland Heights, Mo (G.M.G.); Duke University, U.S. Department of Veterans Affairs, Durham, NC (R.H.S.); Rollins School of Public Health, Emory University, Atlanta, Ga (J.M.S.); and Mayo Clinic, Rochester, Minn (R.J.V.)
| | - Charles E Chambers
- From the Department of Radiology, University of New Mexico, 3004 La Mancha Dr NW, Albuquerque, NM 87104 (F.A.M.); Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Md (M.M.); Department for Quality and Safety, American College of Radiology, Reston, Va (M.B.C.); Departments of Radiology and Medicine, Penn State Hershey Medical Center, Hershey, Pa (C.E.C.); Radiation Section, Louisiana Department of Environmental Quality, West Monroe, La (J.G.E.); Department of Radiology, Stanford University, Stanford, Calif (D.P.F.); Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M., D.C.S.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (H.D.R.); Department of Radiation Oncology, University of Rochester, Rochester, NY (M.T.M.); Radiation Studies Section, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Ga (A.J.A.); Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Fla (W.E.B.); Department of Radiology, Logan University, Maryland Heights, Mo (G.M.G.); Duke University, U.S. Department of Veterans Affairs, Durham, NC (R.H.S.); Rollins School of Public Health, Emory University, Atlanta, Ga (J.M.S.); and Mayo Clinic, Rochester, Minn (R.J.V.)
| | - Jennifer G Elee
- From the Department of Radiology, University of New Mexico, 3004 La Mancha Dr NW, Albuquerque, NM 87104 (F.A.M.); Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Md (M.M.); Department for Quality and Safety, American College of Radiology, Reston, Va (M.B.C.); Departments of Radiology and Medicine, Penn State Hershey Medical Center, Hershey, Pa (C.E.C.); Radiation Section, Louisiana Department of Environmental Quality, West Monroe, La (J.G.E.); Department of Radiology, Stanford University, Stanford, Calif (D.P.F.); Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M., D.C.S.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (H.D.R.); Department of Radiation Oncology, University of Rochester, Rochester, NY (M.T.M.); Radiation Studies Section, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Ga (A.J.A.); Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Fla (W.E.B.); Department of Radiology, Logan University, Maryland Heights, Mo (G.M.G.); Duke University, U.S. Department of Veterans Affairs, Durham, NC (R.H.S.); Rollins School of Public Health, Emory University, Atlanta, Ga (J.M.S.); and Mayo Clinic, Rochester, Minn (R.J.V.)
| | - Donald P Frush
- From the Department of Radiology, University of New Mexico, 3004 La Mancha Dr NW, Albuquerque, NM 87104 (F.A.M.); Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Md (M.M.); Department for Quality and Safety, American College of Radiology, Reston, Va (M.B.C.); Departments of Radiology and Medicine, Penn State Hershey Medical Center, Hershey, Pa (C.E.C.); Radiation Section, Louisiana Department of Environmental Quality, West Monroe, La (J.G.E.); Department of Radiology, Stanford University, Stanford, Calif (D.P.F.); Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M., D.C.S.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (H.D.R.); Department of Radiation Oncology, University of Rochester, Rochester, NY (M.T.M.); Radiation Studies Section, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Ga (A.J.A.); Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Fla (W.E.B.); Department of Radiology, Logan University, Maryland Heights, Mo (G.M.G.); Duke University, U.S. Department of Veterans Affairs, Durham, NC (R.H.S.); Rollins School of Public Health, Emory University, Atlanta, Ga (J.M.S.); and Mayo Clinic, Rochester, Minn (R.J.V.)
| | - Donald L Miller
- From the Department of Radiology, University of New Mexico, 3004 La Mancha Dr NW, Albuquerque, NM 87104 (F.A.M.); Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Md (M.M.); Department for Quality and Safety, American College of Radiology, Reston, Va (M.B.C.); Departments of Radiology and Medicine, Penn State Hershey Medical Center, Hershey, Pa (C.E.C.); Radiation Section, Louisiana Department of Environmental Quality, West Monroe, La (J.G.E.); Department of Radiology, Stanford University, Stanford, Calif (D.P.F.); Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M., D.C.S.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (H.D.R.); Department of Radiation Oncology, University of Rochester, Rochester, NY (M.T.M.); Radiation Studies Section, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Ga (A.J.A.); Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Fla (W.E.B.); Department of Radiology, Logan University, Maryland Heights, Mo (G.M.G.); Duke University, U.S. Department of Veterans Affairs, Durham, NC (R.H.S.); Rollins School of Public Health, Emory University, Atlanta, Ga (J.M.S.); and Mayo Clinic, Rochester, Minn (R.J.V.)
| | - Henry D Royal
- From the Department of Radiology, University of New Mexico, 3004 La Mancha Dr NW, Albuquerque, NM 87104 (F.A.M.); Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Md (M.M.); Department for Quality and Safety, American College of Radiology, Reston, Va (M.B.C.); Departments of Radiology and Medicine, Penn State Hershey Medical Center, Hershey, Pa (C.E.C.); Radiation Section, Louisiana Department of Environmental Quality, West Monroe, La (J.G.E.); Department of Radiology, Stanford University, Stanford, Calif (D.P.F.); Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M., D.C.S.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (H.D.R.); Department of Radiation Oncology, University of Rochester, Rochester, NY (M.T.M.); Radiation Studies Section, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Ga (A.J.A.); Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Fla (W.E.B.); Department of Radiology, Logan University, Maryland Heights, Mo (G.M.G.); Duke University, U.S. Department of Veterans Affairs, Durham, NC (R.H.S.); Rollins School of Public Health, Emory University, Atlanta, Ga (J.M.S.); and Mayo Clinic, Rochester, Minn (R.J.V.)
| | - Michael T Milano
- From the Department of Radiology, University of New Mexico, 3004 La Mancha Dr NW, Albuquerque, NM 87104 (F.A.M.); Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Md (M.M.); Department for Quality and Safety, American College of Radiology, Reston, Va (M.B.C.); Departments of Radiology and Medicine, Penn State Hershey Medical Center, Hershey, Pa (C.E.C.); Radiation Section, Louisiana Department of Environmental Quality, West Monroe, La (J.G.E.); Department of Radiology, Stanford University, Stanford, Calif (D.P.F.); Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M., D.C.S.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (H.D.R.); Department of Radiation Oncology, University of Rochester, Rochester, NY (M.T.M.); Radiation Studies Section, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Ga (A.J.A.); Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Fla (W.E.B.); Department of Radiology, Logan University, Maryland Heights, Mo (G.M.G.); Duke University, U.S. Department of Veterans Affairs, Durham, NC (R.H.S.); Rollins School of Public Health, Emory University, Atlanta, Ga (J.M.S.); and Mayo Clinic, Rochester, Minn (R.J.V.)
| | - David C Spelic
- From the Department of Radiology, University of New Mexico, 3004 La Mancha Dr NW, Albuquerque, NM 87104 (F.A.M.); Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Md (M.M.); Department for Quality and Safety, American College of Radiology, Reston, Va (M.B.C.); Departments of Radiology and Medicine, Penn State Hershey Medical Center, Hershey, Pa (C.E.C.); Radiation Section, Louisiana Department of Environmental Quality, West Monroe, La (J.G.E.); Department of Radiology, Stanford University, Stanford, Calif (D.P.F.); Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M., D.C.S.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (H.D.R.); Department of Radiation Oncology, University of Rochester, Rochester, NY (M.T.M.); Radiation Studies Section, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Ga (A.J.A.); Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Fla (W.E.B.); Department of Radiology, Logan University, Maryland Heights, Mo (G.M.G.); Duke University, U.S. Department of Veterans Affairs, Durham, NC (R.H.S.); Rollins School of Public Health, Emory University, Atlanta, Ga (J.M.S.); and Mayo Clinic, Rochester, Minn (R.J.V.)
| | - Armin J Ansari
- From the Department of Radiology, University of New Mexico, 3004 La Mancha Dr NW, Albuquerque, NM 87104 (F.A.M.); Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Md (M.M.); Department for Quality and Safety, American College of Radiology, Reston, Va (M.B.C.); Departments of Radiology and Medicine, Penn State Hershey Medical Center, Hershey, Pa (C.E.C.); Radiation Section, Louisiana Department of Environmental Quality, West Monroe, La (J.G.E.); Department of Radiology, Stanford University, Stanford, Calif (D.P.F.); Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M., D.C.S.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (H.D.R.); Department of Radiation Oncology, University of Rochester, Rochester, NY (M.T.M.); Radiation Studies Section, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Ga (A.J.A.); Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Fla (W.E.B.); Department of Radiology, Logan University, Maryland Heights, Mo (G.M.G.); Duke University, U.S. Department of Veterans Affairs, Durham, NC (R.H.S.); Rollins School of Public Health, Emory University, Atlanta, Ga (J.M.S.); and Mayo Clinic, Rochester, Minn (R.J.V.)
| | - Wesley E Bolch
- From the Department of Radiology, University of New Mexico, 3004 La Mancha Dr NW, Albuquerque, NM 87104 (F.A.M.); Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Md (M.M.); Department for Quality and Safety, American College of Radiology, Reston, Va (M.B.C.); Departments of Radiology and Medicine, Penn State Hershey Medical Center, Hershey, Pa (C.E.C.); Radiation Section, Louisiana Department of Environmental Quality, West Monroe, La (J.G.E.); Department of Radiology, Stanford University, Stanford, Calif (D.P.F.); Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M., D.C.S.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (H.D.R.); Department of Radiation Oncology, University of Rochester, Rochester, NY (M.T.M.); Radiation Studies Section, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Ga (A.J.A.); Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Fla (W.E.B.); Department of Radiology, Logan University, Maryland Heights, Mo (G.M.G.); Duke University, U.S. Department of Veterans Affairs, Durham, NC (R.H.S.); Rollins School of Public Health, Emory University, Atlanta, Ga (J.M.S.); and Mayo Clinic, Rochester, Minn (R.J.V.)
| | - Gary M Guebert
- From the Department of Radiology, University of New Mexico, 3004 La Mancha Dr NW, Albuquerque, NM 87104 (F.A.M.); Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Md (M.M.); Department for Quality and Safety, American College of Radiology, Reston, Va (M.B.C.); Departments of Radiology and Medicine, Penn State Hershey Medical Center, Hershey, Pa (C.E.C.); Radiation Section, Louisiana Department of Environmental Quality, West Monroe, La (J.G.E.); Department of Radiology, Stanford University, Stanford, Calif (D.P.F.); Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M., D.C.S.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (H.D.R.); Department of Radiation Oncology, University of Rochester, Rochester, NY (M.T.M.); Radiation Studies Section, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Ga (A.J.A.); Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Fla (W.E.B.); Department of Radiology, Logan University, Maryland Heights, Mo (G.M.G.); Duke University, U.S. Department of Veterans Affairs, Durham, NC (R.H.S.); Rollins School of Public Health, Emory University, Atlanta, Ga (J.M.S.); and Mayo Clinic, Rochester, Minn (R.J.V.)
| | - Robert H Sherrier
- From the Department of Radiology, University of New Mexico, 3004 La Mancha Dr NW, Albuquerque, NM 87104 (F.A.M.); Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Md (M.M.); Department for Quality and Safety, American College of Radiology, Reston, Va (M.B.C.); Departments of Radiology and Medicine, Penn State Hershey Medical Center, Hershey, Pa (C.E.C.); Radiation Section, Louisiana Department of Environmental Quality, West Monroe, La (J.G.E.); Department of Radiology, Stanford University, Stanford, Calif (D.P.F.); Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M., D.C.S.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (H.D.R.); Department of Radiation Oncology, University of Rochester, Rochester, NY (M.T.M.); Radiation Studies Section, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Ga (A.J.A.); Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Fla (W.E.B.); Department of Radiology, Logan University, Maryland Heights, Mo (G.M.G.); Duke University, U.S. Department of Veterans Affairs, Durham, NC (R.H.S.); Rollins School of Public Health, Emory University, Atlanta, Ga (J.M.S.); and Mayo Clinic, Rochester, Minn (R.J.V.)
| | - James M Smith
- From the Department of Radiology, University of New Mexico, 3004 La Mancha Dr NW, Albuquerque, NM 87104 (F.A.M.); Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Md (M.M.); Department for Quality and Safety, American College of Radiology, Reston, Va (M.B.C.); Departments of Radiology and Medicine, Penn State Hershey Medical Center, Hershey, Pa (C.E.C.); Radiation Section, Louisiana Department of Environmental Quality, West Monroe, La (J.G.E.); Department of Radiology, Stanford University, Stanford, Calif (D.P.F.); Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M., D.C.S.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (H.D.R.); Department of Radiation Oncology, University of Rochester, Rochester, NY (M.T.M.); Radiation Studies Section, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Ga (A.J.A.); Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Fla (W.E.B.); Department of Radiology, Logan University, Maryland Heights, Mo (G.M.G.); Duke University, U.S. Department of Veterans Affairs, Durham, NC (R.H.S.); Rollins School of Public Health, Emory University, Atlanta, Ga (J.M.S.); and Mayo Clinic, Rochester, Minn (R.J.V.)
| | - Richard J Vetter
- From the Department of Radiology, University of New Mexico, 3004 La Mancha Dr NW, Albuquerque, NM 87104 (F.A.M.); Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Md (M.M.); Department for Quality and Safety, American College of Radiology, Reston, Va (M.B.C.); Departments of Radiology and Medicine, Penn State Hershey Medical Center, Hershey, Pa (C.E.C.); Radiation Section, Louisiana Department of Environmental Quality, West Monroe, La (J.G.E.); Department of Radiology, Stanford University, Stanford, Calif (D.P.F.); Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M., D.C.S.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (H.D.R.); Department of Radiation Oncology, University of Rochester, Rochester, NY (M.T.M.); Radiation Studies Section, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Ga (A.J.A.); Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Fla (W.E.B.); Department of Radiology, Logan University, Maryland Heights, Mo (G.M.G.); Duke University, U.S. Department of Veterans Affairs, Durham, NC (R.H.S.); Rollins School of Public Health, Emory University, Atlanta, Ga (J.M.S.); and Mayo Clinic, Rochester, Minn (R.J.V.)
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