Radiological protection of patients: conceptual framework and new international recommendations

Medical exposures represent the largest man-made source of radiation exposure. Within the concept medical exposures includes different kind of exposure: of patients as part of their own medical diagnosis or treatment; of individuals as part of occupational health surveillance; of individuals as part of health screening programs; of volunteers participating in biomedical research programs; of individuals as part of medico-legal procedures and of voluntary patient caregivers (relatives or friends). Radiological protection of patients (RPP) is founded on two basic principles: justification and optimization. The justification of a medical exposure is founded in the consideration that it will give a sufficient net benefit, including the direct health benefits to the patients and the potential benefits to society, against the individual detriment that the exposure might cause, taking into account the efficacy, benefits and risks of available alternative techniques having the same objective but involving no or less exposure to ionizing radiation. Concerning optimization in diagnosis, the radiological protection objective is to keep doses as low as reasonably achievable while obtaining the necessary diagnostic information. In therapy, the objective is to ensure that the target tissue is given the prescribed dose while minimizing the dose to surrounding healthy tissue. In this presentation we analyze new international recommendations concerning RPP, with emphasis in the Directive 97/43/EURATOM. The importance of referral guidelines to help physicians during the process of justification and use of diagnostic reference levels (to help in optimization) is discussed. (author)