RRSC Standard Language for a protocol or study consent form

For more information contact Will Davidson at

Studies Involving Research Radiation

15.3Studies Involving Radiation, Radiotracers and/or Radiological Imaging Modalities

If your protocol involves exposure to ionizing radiation solely as a result of a subject’s participation in the research protocol, please select one of the following risk language templates:

  • Radiation Exposure Occurs Solely Because of Participation in the Research Protocol:
  • This research study involves exposure to radiation from ***. Therefore, you will receive a radiation dose. This radiation dose is not necessary for your medical care and will occur only as a result of your participation in the study. At doses much higher than you will receive, radiation is known to increase the risk of developing cancer after many years. At the doses you will receive, it is very unlikely that you will see any effects from the radiation dose.
  • Radiation Exposure May Occur Because of Participation in the Research Protocol:
  • This research study may involve exposure to radiation from ***. Therefore, you may receive a radiation dose. This radiation dose would not be necessary for your medical care and would occur only as a result of your participation in the study. At doses much higher than you would receive, radiation is known to increase the risk of developing cancer after many years. At the doses you will receive, it is very unlikely that you will see any effects from the radiation dose.
  • Of the Radiation exposure That Does Occur, Only Part of it Will be Because of Participation in the Research Protocol:
  • This research study involves exposure to radiation from ***. Therefore, you will receive a radiation dose. Some of these procedures may not be necessary for your medical care and will occur only as a result of your participation in the study. At doses much higher than you will receive, radiation is known to increase the risk of developing cancer after many years. At the doses you will receive, it is very unlikely that you will see any effects from the radiation dose.

***put the type of imaging modality here

Examples:

  • X-rays (CT scan, chest x-ray, hand/wrist x-ray, abdomen x-ray, DEXA, pQCT, Fluoroscopy/Angiography)
  • Nuclear Medicine scans (FDG-PET, PET/CT, Tc-99m, SPECT, MUGA, bone scan)

If you have any questions, please contact Will Davidson at 215-898-2133.

Radioactive/Imaging tracers: Are research subjects receiving a radioactive drug and/or contrast agent?

Yes No

If yes, Please contact The Radiology IND Office for more details: or call 215-349-5891

Ultrasound: Are research subjects undergoing an Ultrasound?

Yes No

If yes, Please contact Susan Schultz at