The Missing Piece in Medical Imaging Safety with Dr. Madan Rehani

In this episode of Frame by Frame: Rethink Imaging, host Chris St John sits down with Dr. Madan Rehani, Professor at Harvard Medical School and Director of Radiation Protection Outreach at Mass General, to explore the risks and realities of cumulative radiation exposure in medical imaging. Drawing from his global leadership experience at the International Atomic Energy Agency, Dr. Rehani shares evidence-based insights on dose tracking, the limitations of CT safety, and why patient protection must evolve alongside technology. Whether you’re a radiologist, medical physicist, or healthcare leader, this episode offers a timely conversation on rethinking radiation safety in the modern age.

In this episode of Frame by Frame: Rethink Imaging, host Chris St John welcomes Dr. Madan Rehani, a globally recognized expert in radiation protection, to examine the complexities of cumulative radiation dose tracking in diagnostic imaging.

With a career spanning Harvard Medical School, Massachusetts General Hospital, and more than a decade at the International Atomic Energy Agency, Dr. Rehani brings unparalleled insight into how the medical community can better manage radiation risk. He discusses how uncertainty in radiation effects should inspire prudent safeguards—not paralysis—especially when balancing clinical benefits with long-term exposure concerns.

Together, they explore the key differences in radiation policy between the U.S. and Europe, the underutilized potential of existing dose-reduction technologies, and how CT scans—often assumed to be “low dose”—still warrant caution. Dr. Rehani introduces tiered safety systems modeled after traffic light warnings and emphasizes how public pressure could help shift outdated safety practices.

This conversation is a must-listen for imaging professionals, healthcare decision-makers, and anyone interested in the evolving science of radiation safety.

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What You'll Learn:

Why cumulative dose tracking should guide—not scare—clinical decision-making
How modern dose-reduction technology is available but underutilized
What global differences in radiation protection reveal about safety culture
How CT scans still carry significant radiation risks and where manufacturers can improve
The role of tiered dose thresholds and how they mirror traffic light systems in medication safety
Why patient communication is essential in shifting outdated safety perceptions
How public advocacy may be the key to wider adoption of dose-reduction measures
The urgent need for clearer protocols in cumulative dose tracking and accountability

Chapters:

[00:00] Intro: Managing Uncertainty in Medical Radiation

[00:02:34] From Hospital Physicist to Global Safety Leader: Dr. Rehani's Journey

[00:07:45] The US vs Europe: Different Approaches to Radiation Protection

[00:11:20] Traffic Light Analogy: Rethinking Radiation Safety Systems

[00:17:09] Using Dose History as a Clinical Compass, Not a Source of Fear

[00:28:50] Untapped Technologies: Why CT Isn't Yet a Low-Dose Modality

[00:36:11] Hard Truths About Cumulative Radiation Exposure

[00:37:43] Closing Thoughts: The Future of Medical Imaging Safety