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Table of Contents

LIST OF ABBREVIATIONS ... 4

I. GENERAL INTRODUCTION ... 5

1. Foreword ... 5

2. Effects of Radiation Exposure on Living Organisms ... 5

2.1. Units of Measurement ... 5

2.2. X-ray Radiation ... 5

2.3. Nuclear Weapons ... 6

2.4. Nuclear Accidents ... 8

2.5. Summary of Effects of Radiation Exposure on Humans ... 9

3. Radiation Exposure from Medical Imaging ... 11

4. Methods for Measuring Dose Exposure in Medical Imaging ... 11

5. Methods for Dose Reduction ... 12

5.1. Justification ... 12

5.2. Optimization ... 13

5.2.1. Technical Advances ... 13

5.2.2. Optimization of Acquisition Protocols and Parameters ... 16

5.3. Limits and Regulation ... 16

II. RAISED QUESTIONS ... 18

III. SUMMARIES OF ORIGINAL STUDIES ... 19

1. Study 1: Organ-Based Tube Current Modulation: Are Women’s Breasts Positioned in the Reduced-Dose Zone? ... 19

1.1. Purpose ... 19

1.2. Materials and Methods ... 19

1.3. Results ... 19

1.4. Conclusion ... 19

2. Study 2: CT Dose Survey in Adults: What Sample Size for What Precision? ... 27

2.1. Purpose ... 27

2.2. Materials and Methods ... 27

2.3. Results ... 27

2.4. Conclusions ... 27

3. Study 3: X-ray Examination Dose Surveys: How Accurate Are my Results? ... 37

3.1. Purpose ... 37

3.2. Materials and Methods ... 37

3.3. Results ... 37

3.4. Conclusion ... 37

4. Study 4: Are Referral Guidelines for CT Examinations Addressing all Clinical Scenarios? A comparison of EURO-2000 Guidelines and ESR iGuide. ... 45

Eur Radiol (Submitted) ... 45

4.1. Purpose ... 45

4.2. Materials and Methods ... 45

4.3. Results ... 45

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IV. SUMMARY OF THE RESULTS – ADVANCES IN KNOWLEDGE ... 69

V. DISCUSSION ... 70

1. Position of Women’s Breasts in Relation to Organ-Based Tube Current Modulation ... 70

2. Dose Survey Sample Sizes ... 71

3. Imaging Guidelines ... 72

VI. CONCLUSIONS AND PERSPECTIVES ... 73

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