A study reported in the New England Journal of Medicine may add some urgency to the effort to rationalize imaging procedures. (NEJM Article) Imaging, particularly advanced types such as MRI, CAT and PET scans, has shown very rapid growth and has been a significant contributor to health cost increases. The private sector has launched a number of programs to control use of imaging, with some success. There have been discussions and proposals to use similar techniques to control how much Medicare pays for scanning. The NEJM report looked at a large private insurer database to estimate the amount of ionizing radiation adults are receiving. Ionizing radiation can contribute to health problems, including causing cancer. The study found that many adults are getting relatively high cumulative doses of this radiation. While the study did not look specifically at health problems caused by the radiation received, it raises caution flags because there is a high likelihood that there are some additional health issues created for the people receiving this much ionizing radiation. The study therefore will likely be used as a further reason to control inappropriate imaging.