Cumulative radiation dose from multiple CT examinations: stronger justification, fewer repeats, or dose reduction technology needed?

• Clinical decision support systems for imaging referral provide generic justification for the clinical situation, but personal justification is needed particularly when dose is high or when the patient is sensitive to the effects of radiation. • Strategies to address cumulative high doses include stronger justification between radiologists and referrers; guidance for the frequency of surveillance procedures; and the drive to reduce CT doses through innovation in industry.

Monitoring of clinical imaging guidelines part 3: norms, standards, and regulations.

It is known that the use of imaging in clinical situations is not always optimal, leading to suboptimal health care and potential radiation risk. There may be overuse of imaging, underuse, or use of the wrong modality. The use of clinical imaging guidelines is likely to improve the use of imaging, but roadblocks exist.

Clinical imaging guidelines part 1: a proposal for uniform methodology.

Inappropriate imaging can lead to unnecessary medical radiologic exposures and cost and may not answer the clinical question. Imaging referral guidelines inform the justification of radiologic procedures and facilitate the choice of the best test first, but their acceptance by referrers, use, and value may be limited by shortcomings in the methodology of development. Focusing on common, essential elements of methodology will help guideline developers.

Proceedings from the first Global Summit on Radiological Quality and Safety.

The ACR, the European Society of Radiology, and the International Society of Radiology held the first joint Global Summit on Radiological Quality and Safety in May 2013. The program was divided into 3 day-long themes: appropriateness of imaging, radiation protection/infrastructure, and quality and safety. Participants came from global organizations, including the International Atomic Energy Agency, the World Health Organization, and other institutions; industry and patient advocacy groups with an interest in imaging were also represented.

European survey on imaging referral guidelines.

Unlabelled: The objective of this study was to devise and implement a Europe-wide study on referral guidelines for radiological imaging in the EU Member States in order to identify potential major issues, important differences between Member States and good practices. A web-based survey was used to assess the availability of imaging referral guidelines, development methodology and preferences for future initiatives for European community action to facilitate justification and appropriate use of radiological diagnostic procedures. A questionnaire was distributed to representatives of national radiological and nuclear medicine societies as well as to competent authorities for radiation protection in 30 European countries, including all 28 EU Member States.

Imaging referral guidelines in Europe: now and in the future-EC Referral Guidelines Workshop Proceedings.

Unlabelled: As an integral part of the European Commission (EC) Imaging Referral Guidelines Project a 1.5-day workshop was held in Vienna on 20-21 September, 2012. At this workshop, models and good practices regarding the appropriateness and use of imaging referral guidelines (Guidelines) in Europe and worldwide were presented, together with the results of a survey of Guidelines in Europe.

Justification: how to get referring physicians involved.

Barriers to involvement of clinicians in the process of justification include an already overloaded knowledge base, lack of time, inconsistent guidance and disproportionate patient expectations. Strategies to improve referring physicians' input include education, use of imaging referral guidelines, clinical audit and regulation. This article discusses and reviews evidence for approaches to encourage greater participation in justification by clinicians.

Achilles tendon rupture in an elite athlete following multiple injection therapies.

Achilles tendinopathy is common, and its management continues to be challenging, especially in elite athletes. Despite a wide range of novel management options, none guarantees a rapid return to high level sporting activity. Eccentric exercise has been shown to reduce symptoms and normalise imaging abnormalities, but time constraints on professional athletes often make this an unrewarding isolated management strategy.