Shouldn't the description of the risks of GDD be told in advance to all patients undergoing MRI, and not just target those who have already developed subtle disease?
Yes, I believe that more information should be provided to all patients. I have written several the peer-reviewed literature on the subject of providing informed consent to patients in Radiology.
It's also important to acknowledge that effective change is almost always an incremental process. To push for too much all at once can be a recipe for opposition and rejection. I value a realistic and pragmatic approach to change.
Ultimately, what is needed is a comprehensive and complete communication of risks in Radiology - a number of the alternatives are even worse. I believe patients should be made aware of these risks in advance, but at the very same time they need to be aware of the risks of alternative procedures: of cancer development from x-rays in CT, contrast media acute kidney injury from iodine contrast in CT, radio-activity and medical radiation in nuclear medicine, microbubbles in contrast enhanced ultrasound, and critically, the relative incidence of each severe complication. Patients need the full story told to them of all the severe complications for each of the various studies they may undergo.
I am a strong proponent of information in Radiology. You cannot pick one risk out from one of the modalities, while leaving all the others unsaid > it leaves the patients in the same predicament and perhaps even worse than they are now, if it drives them to undergo even riskier procedures. What is needed is a complete and comprehensive description of the severe risks in Radiology and their likelihoods/relative risks. What is needed is a global risk description for all Radiology exams in a consent form > stay tuned for a future blog on this.