WHY ARE THESE IMPORTANT?

• Radiation exposure for medical purposes is increasing all the time,
particularly the high-end procedures such as CT.

• Because imaging is so quick and the image quality so good, we often forget that there has been a significant radiation exposure to achieve the results.

• Whilst the exposure is usually fully justified and there are obvious clinical benefits, it is good practice to constantly balance the pros and cons of a procedure.

• As the radiologist has the legal responsibility for the radiation exposure and has the technical knowledge of the radiation dose for a given exposure, it is important that they have the clinical information to balance the risks.

• The risks of a given exposure are often downplayed but there is incomplete evidence on the biological effects of ionising radiation and prudence would seem the safest approach.

JUSTIFICATION

• Every radiation exposure no matter how small must be justified on clinical grounds.

• The referral form should have sufficient clinical information for the radiologist (who is responsible for the exposure) to be able to justify
the exposure.

OPTIMISATION

• Every radiation exposure will be optimised and performed according to current practising guidelines for safe practice.

• This applies mainly to radiographic technique, but also to view selection for the given clinical indications.

These principles can be summarised in the ALARA statement:
• As Low As Reasonably Achievable

• This refers to good radiographic technique. But also requires that we question each exposure, is it really necessary? Is there another way of acquiring the information not using Ionising radiation? Can we minimise the exposure?