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When doctors want to find what’s wrong with you, they order blood tests and scans. Blood tests are safe. But because there are many types of imaging methods, it’s not easy to choose the best one, or the safest.

There are no universal guidelines to picking the right scan. The best choice of medical imaging scans is the one that provides the highest diagnostic value with the lowest risk to patient and technicians.

Avoid Excess Radiation Exposure

X-rays, CT and PET scans, mammograms, and DEXA bone density scans involve radiation. Breast and bone density scans have sensors that detect radiation as it passes through bone and abnormal tissue. The focused radiation gets converted by a computer to create medical images used to assess patients.

DEXA scans use one-tenth the amount of radiation as a chest X-ray. DEXA is the gold standard for measuring bone mineral density to determine bone loss associated with osteoporosis. A DEXAFit scan accurately measures body fat to determine body composition. DEXAFit information is used to customize fitness training programs by targeting areas for precise muscle gain and fat loss.

PET scans are a type of CT that requires drinking a radioactive substance to highlight abnormal tissue. A PET scan shows areas with increased metabolic activity, like tumors. A CT scan is best for anatomical details. SPECT brain scans and brain perfusion imaging also involve radiation.

Radiation from medical imaging scans increases cancer risk. Even though modern mammography uses low radiation machines, getting a mammogram every year over a lifetime can increase your risk for breast and lung cancer.

Can Ultrasound Imaging Replace Radioactive Scans?

Ultrasound (US) uses high-frequency sound waves that echo off tissue that are converted by a computer to blurry images. It takes training to read an US scan. An US is the first choice for scans of the liver and gallbladder, uterus and ovaries, and prostate gland. Other uses include imaging of the breast and for examining a fetus during pregnancy.

Portable US units for in-office use are valuable in detecting fractures of small bones like the wrist. US also provides real-time imaging of tendons, muscles, and ligaments, including attachment at bone surfaces or for assessing soft-tissue tears. In our office, we use a portable US for precision placement of injections or insertion of acupuncture needles.

Are MRIs Safe?

Magnetic resonance imaging (MRI) scans use a magnetic field to make pictures of organs and body structure. Most MRI scans are used to view the brain or spinal column. But MRIs are also used to determine breast and prostate cancer. An MRI provides different information about body tissues and structure than an X-ray, US, or CT scan. Images from an MRI can often detect problems not seen by other imaging methods.

MRIs are my first choice for evaluating torn ligaments and worn cartilage in the knee, ruptured discs in the low back, and in the evaluation of breast tissue for cancer. Other uses include evaluating eyes, sinuses, and ears; and for spinal tumors. I use MRIs for brain imaging to detect tumors.

MRIs do not involve radiation, so they are considered safe. But since an MRI uses a powerful magnet, tell the radiology technician of any implanted medical devices or embedded metal like pierced jewelry, stents or shunts, surgical screws or plates, dental posts, artificial joints, metals fragments from work or military accidents.

Bottom Line on Medical Imaging

Low dose radiation exposure over a lifetime, including from medical imaging, increases cancer risk. Younger people should avoid medical imaging unless truly necessary. Pregnant women and for those attempting pregnancies should avoid imaging that involves radiation. When possible, choose an US or MRI because they do not involve radiation.

Medical scans can be expensive. But, you can get medical imaging on our own. Independent, free-standing imaging centers offer competitive cash pricing. X-rays can range from $75 to about $200. Prices for US also vary, but are generally affordable. The cost for a DEXA scan is reasonable, ranging between $55 up to $175. CT scans and MRIs are more expensive. PET and SPECT scans are pricey.

If you have health insurance, get a prescription from your doctor to increase your chances of coverage. Make sure the imaging lab gets preauthorization. However, if you have to pay cash, you’ll find that competition among radiology clinics is intense, so cash discounts are often available. Shop around and compare prices.

Dr. J. E. Williams


Dr. Williams is a pioneer in integrative and functional medicine, the author of six books, and a practicing clinician with over 100,000 patient visits. His areas of interest include longevity and viral immunity. Formerly from San Diego, he now resides in Sarasota, Florida and practices at the Florida Integrative Medical Center. He teaches at NOVA Southeastern University and Emperor’s College of Oriental Medicine.

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