SESSION 7. RADIATION IN MEDICAL USE: Medical use of ionising radiation ― challenges for the third millennium

摘要

Ionising radiation has been at the healthcare's service for more than a century and there are no indications that this will change in the foreseeable future. In total the benefit is outweighing by far the deleterious effects caused by radiation. But there is a large potential for improvements. In some applications the radiation dose can be reduced without jeopardising the medical objective, in other cases alternative methods without the use of ionising radiation could be a better option. In some cases the use of ionising radiation is totally unnecessary if e.g. the result of the diagnosis is of no significance at all for the patient. From the diversity of application areas some can be mentioned that are entailing special requirements on radiation protection in the near future. Generally the development is going more and more towards complex equipment and methods. The radiation protection conditions may be difficult to grasp when dealing with advanced technology equipped with many automatic functions, and it may be difficult to choose the correct settings or to adapt parameters for the actual application. Efforts are necessary concerning the equipment with e.g. standards prescribing that the settings must be flexible for adaptation to the various clinical situations, and user-friendly documentation of the equipment must be provided. On the user side the major demands are education, education and education. This is of special relevance when advanced equipment is located outside the traditional clinics in an environment with lacking radiation protection competence among the users - a trend that can be observed more and more. Justification is another area of interest. The new examination methods as e.g. the new applications of computed tomography must be scrutinised from the patient's perspective. Is really the examination from the top to the toe to the benefit for the patient, or is it performed on flimsy grounds? This question must be asked and answered for all examinations that are planed, but it is especially important for new procedures with new technology in order to avoid the introduction of a practice that is inferior from a radiation protection point of view.