Tehran University Medical Journal (Oct 2016)
Review on radiation protection in diagnostic radiology
Abstract
Discovery of x-ray and using of it for medical imaging have produced tremendous outcomes for diagnosis and treatment of diseases. More than 10 million diagnostic radiological procedures and 100,000 nuclear medicine exams are being performed daily around the world. According to the national commission on radiological protection and measurements (NCRP)-report 160, medical x-ray is contribute to approximately 95% of all radiological examinations that is responsible for 74% of the collective dose to the US population. Despite of unique benefits of ionizing radiations, in the field of radiation protection, they are associated with potential risks such as cancer and genetically abnormalities. The cancer risk attributable to diagnostic radiology is estimated about 0.6% to 3%. It is estimated that the radiation dose from diagnostic x-ray procedures are annually responsible for 7,587 and 5,695 cases of radiation induced cancer in the population of Japan and US, respectively. Although the radiation dose associated with most radiological procedures are very low, but rapid increasing use of radiography procedures during two past decades have been concerned due to the cancer risk associated with ionizing radiations. On the base of linear no-threshold (LNT) model of dose-response curve, any level of exposure is dangerous. Deoxyribonucleic acid (DNA) is the main target of ionizing radiation. For radiological exposure with low dose, the stochastic effects such as genetic damages and leukemia are concerned. According to the recommendations of the radiation protection regulatory organizations, radiological procedure must be done with respect to social and economic factors in which exposure of patient and population kept as low as reasonable and achievable. Hence, prescription of a radiological test is acceptable only when its advantages are higher than its damages. Optimizing the different parameters such as: collimating the primary beam field to the area of diagnostic interest, exposure conditions (high kVp and low mAs), projections, exposure time and shielding can reduce the patients' exposure besides the saving of image quality. Following the radiation protection guidelines can considerably decrease the exposure risks.
