Managing Radiation Use in Medical Imaging: A Multifaceted Challenge

Abstract

This special report aims to inform the medical community about the many challenges involved in managing radiation exposure in a way that maximizes the benefit-risk ratio. The report discusses the state of current knowledge and key questions in regard to sources of medical imaging radiation exposure, radiation risk estimation, dose reduction strategies, and regulatory options.

An education and training programme for radiological institutes: impact on the reduction of the CT radiation dose

“…MRI, ultrasound) [29] • Limit the imaging range to the area of interest, for follow-up studies in particular [44] • Prevent the extend beyond the anatomic limits (e.g., thorax, abdomen) which does not add clinically important information [7] • Position the arms above the shoulders during chest CT [45] • Position the patient precisely in the gantry [12,46,47] brain, chest and pulmonary arteries (Table 4). Compared with the control period, the average reduction in the DLP in the follow-up period was 37% for the sinuses (P<0.001), 9% for the brain (P<0.05), 24% for the chest (P<0.05), and 42% for the pulmonary arteries (P<0.001).…”

“…A specially designed webpage (www.ct-consulting.ch) provides relevant information from our service and allows communication with the members of our radiation consulting team and service reservation. Reduction of the CT radiation dose requires a multifaceted approach, as suggested by Hricak et al [29]. Three major components have to be considered for successful dose optimisation in CT: (a) implementation of dosereduction techniques, (b) use of clinical decision guidelines and (c) application of education and training programmes.…”

ALARA, Image Gently and CT-induced cancer

“…Although many radiology publications indicate that cancer risks from CT scans are extremely small, this is unfortunately not always the case [4,11,23,32,[35][36][37][38][39][40][41][42].…”

The Quality/Safety Medical Index: a Standardized Method for Concurrent Optimization of Radiation Dose and Image Quality in Medical Imaging

“…While there is no detrimental impact on image quality for higher-dose CT protocols, these do come at the cost of increased (and often unnecessary) radiation exposure levels. While a number of CT radiation dose reduction strategies have been reported [14][15][16][17][18][19], the ensuing interaction effects that these have on image quality have not been critically analyzed and should be required for any comprehensive approach to combined safety and quality analysis.…”