Sustainability of medical imaging

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Abstract
Exposure to medical radiation Use of radiation for medical examinations and tests is the largest manmade source of radiation exposure. The biological effect of radiation dose received is expressed in milliSievert (mSv). According to the latest estimation of the United Nations, an average of 2.4 mSv/year comes from natural sources.1 The medical sources of radiation were about one fifth of the natural radiation in 1987,2 close to half in 1993,3 and almost 100% of natural radiation in 1997 in most affluent countries (fig 1).4 In 1997, the German Federal Office for Radiation Protection reported 136 million x ray examinations and 4 million nuclear medicine diagnostic tests, resulting in a mean effective dose of 2.15 mSv per person per year.4 View larger version: In this window In a new window Fig 1 Medical and natural sources of radiation 3 Dimensional reconstruction of child's head from computed tomography data Credit: PHILLIPPE PLAILLY/SPL The use of procedures with a high load of radiation continues to grow steadily.5 The medical sources of radiation in industrialised countries may therefore soon be greater than natural sources. Ivan Illich wrote in 1976 (at the beginning of the imaging era): “Act so that the effect of your action is compatible with the permanence of genuine human life. Very concretely applied this could mean: Do not raise radiation levels unless you know that this action will not be visited upon your grandchild.”6 The contemporary practice of imaging seems to ignore this sound advice.