PDF(Pubmed)
Abstract：
Ionising radiation stands as an indispensable protagonist in the narrative of medical imaging, underpinning diagnostic evaluations and therapeutic interventions across an array of medical conditions. However, this protagonist poses a paradox - its inestimable service to medicine coexists with an undercurrent of potential health risks, primarily DNA damage and subsequent oncogenesis. The narrative of this comprehensive review unfurls around this intricate enigma, delicately balancing the indispensable diagnostic utility against the non-negotiable commitment to patient safety. In this critical discourse, the intricacies of ionising radiation are dissected, illuminating not only its sources but also the associated biological and health hazards. The exploration delves into the labyrinth of strategies currently deployed to minimise exposure and safeguard patients. By casting light on the scientific nuances of X-rays, computed tomography (CT), and nuclear medicine, it traverses the complex terrain of radiation use in radiology, to promote safer medical imaging practices, and to facilitate an ongoing dialogue about diagnostic necessity and risk. Through a rigorous examination, the pivotal relationship between radiation dose and dose response is elucidated, unravelling the mechanisms of radiation injury and distinguishing between deterministic and stochastic effects. Moreover, protection strategies are illuminated, demystifying concepts such as justification, optimisation, the As Low As Reasonably Achievable (ALARA) principle, dose and diagnostic reference levels, along with administrative and regulatory approaches. With an eye on the horizon, promising avenues of future research are discussed. These encompass low-radiation imaging techniques, long-term risk assessment in large patient cohorts, and the transformative potential of artificial intelligence in dose optimisation. This exploration of the nuanced complexities of radiation use in radiology aims to foster a collaborative impetus towards safer medical imaging practices. It underscores the need for an ongoing dialogue around diagnostic necessity and risk, thereby advocating for a continual reassessment in the narrative of medical imaging.
摘要：
电离辐射是医学成像叙事中不可或缺的主角，支持一系列医疗条件下的诊断评估和治疗干预。然而,这个主角提出了一个悖论——它对医学的不可估量的服务与潜在健康风险的暗流共存，主要是DNA损伤和随后的肿瘤发生。这份全面审查的叙述围绕着这个错综复杂的谜团展开，微妙地平衡了不可或缺的诊断效用与对患者安全的不可谈判的承诺。在这种批判性的话语中，剖析了电离辐射的复杂性，不仅阐明了其来源，而且还阐明了相关的生物和健康危害。这项探索探索了目前为尽量减少暴露和保护患者而部署的策略的迷宫。通过投射X射线的科学细微差别，计算机断层扫描（CT），核医学,它穿越了放射学中辐射使用的复杂地形，为了促进更安全的医疗成像实践，并促进关于诊断必要性和风险的持续对话。通过严格的检查，阐明了辐射剂量和剂量反应之间的关键关系，揭示辐射损伤的机制，区分确定性效应和随机效应。此外，保护策略被照亮，揭开诸如理由之类的概念的神秘面纱，优化，尽可能低的合理实现(ALARA)原则，剂量和诊断参考水平，以及行政和监管方法。一只眼睛在地平线上，讨论了未来研究的有希望的途径。这些包括低辐射成像技术，大型患者队列的长期风险评估，以及人工智能在剂量优化中的变革潜力。对放射学中辐射使用的细微差别复杂性的探索旨在促进对更安全的医学成像实践的协作动力。它强调需要围绕诊断必要性和风险进行持续对话，从而主张对医学成像的叙述进行持续的重新评估。
