Task Group 108
Optimisation of Radiological Protection in Digital Radiography, Fluoroscopy, and CT in Medical Imaging

A Task Group under Committee 3

ICRP has produced a publication on optimisation of protection (Publication 101b) in 2006, but not on issues of optimisation specific to medicine. Guidance has been included in publications dealing with particular techniques (e.g. Publication 121 on paediatric imaging, and Publication 129 on cone beam CT imaging). Previous publications also include Publication 87 on CT, Publication 93 on technical issues in digital imaging, Publication 102 on multi-detector CT, Publication 117 on fluoroscopy, and Publication 120 on cardiology.

Radiology techniques are by far the most common forms of medical imaging performed worldwide. Digital imaging now gives the potential for images to be obtained with lower exposures, enabling levels to be adapted to the diagnostic requirements of particular examinations. However, this facility is often not considered and standard exposure levels are widely used. In addition, new techniques are becoming available that can improve image quality and again enable diagnostic images to be obtained with lower patient doses. However, many users are not deploying these tools effectively, so doses received by patients in many centres are far from optimised.

The mandate of this Task Group is to provide guidance on the need to adopt and adapt levels of dose and image quality to clinical tasks, taking advantage of the wide dynamic range offered by digital imaging equipment. Emphasis will be placed on achieving images that are diagnostic and using images of different quality levels for diagnosis. Methods involved depend on the x-ray technique, for example adapting automatic exposure control settings for digital radiography and making effective use of advanced CT tools such as dual energy, iterative reconstruction, and tube current modulation.

The report to be produced by this Task Group is intended to supersede ICRP Publications 87 and 93. This Task Group will not address nuclear medicine (recently addressed in Publication 128) or dental imaging.

The target audience includes clinical users of machine produced radiation medical imaging equipment, medical physicists, manufacturers, X-ray engineers, applications specialists, and regulators.

Deliverables

• Develop a report for publication in the Annals of ICRP on Application of the Commission’s Recommendation of Optimisation in various imaging modalities;
• Prepare related materials for ICRPaedia;
• Prepare slide sets of each modality chapter including key points for local facility teaching;
• Engage with ICRP liaison organisations and other stakeholders.

Progress to date

The Task Group prepared two reports:

• Optimisation of Radiological Protection in Digital Radiology Techniques for Medical Imaging: covers the principles, approach, personnel and training requirements, and processes that should be in place to implement optimisation in digital radiology. It was acknowledged that the approach needs to be covered in detail, because it had developed so far and then stalled in many imaging departments throughout the world. The guidance provided, is meant to suit radiological departments in many countries with different levels of national radiological protection system development. The report is expected to be published in 2024.
• Practical Aspects in Optimisation of Radiological Protection in Digital Radiography, Fluoroscopy, and CT: covers the detailed practices, methodology, and requirements for individual x-ray modalities. It follows the methods described in previous reports, taking account the developments that have occurred over the last 15 to 20 years, and so replacing some reports from 10 to 20 years ago. The final report is expected to be published in 2025.

 

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Colin Martin (Chair), University of Glasgow, United Kingdom

Kimberly Applegate (Member), University of Kentucky COM (retired), USA

John Damilakis (Member), University of Crete, School of Medicine, Greece

Maria del Rosario Perez (Member), World Health Organisation (WHO), Switzerland

Irene Hernandez-Giron (Member), Leiden University Medical Center (LUMC), The Netherlands

Dina Husseiny (Member), Atomic Energy Authority, Egypt

Helen Khoury (Member), Federal University of Pernambuco, Brazil

Mika Kortesniemi (Member), HUS Diagnostic Center, Helsinki University Hospital, Finland

Dean Pekarovic (Member), Univeristiy Medical Centre Ljubljana, Institute of Radiology, Slovenia

David Sutton (Member), University of Dundee, United Kingdom

Kwan Hoong Ng (Corresponding Member), Universiti Malaya, Malaysia

Jenia Vassileva (Representative), International Atomic Energy Agency (IAEA), Austria