Radioprotection 2025, 60( 1), 9 – 19 © H. Sekkat et al., Published by EDP Sciences, 2025 https:// doi. org / 10.1051 / radiopro / 2024024
Available online at: www. radioprotection. org
ARTICLE
Quality management and certified medical physicist’ s role in radiology for radiation dose optimisation: a literature review until 2024
H. Sekkat 1,*, A. Khallouqi 1, 2, O. El rhazouani 1, A. Halimi 1, K. Elmansouri 1 and Y. Madkouri 3
1 Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan 1 st University, Settat, Morocco. 2 Department of Radiology, Public Hospital, Mediouna, Morocco. 3 Laboratory of Electronic Systems, Information Processing, Mechanics and Energetics, Faculty of Sciences, University Ibn Tofail
Kenitra, Kenitra, Morocco. Received: 7 May 2024 / Accepted: 4 July 2024
Abstract – This review aims to propose effective steps for optimizing radiation doses in radiology, covering both diagnostic and interventional aspects, and to explore associated challenges in dose optimization and quality assessment in radiological departments, emphasizing the role of certified medical physicists. Evidence for cancer risk from radiation doses below 100 mSv remains limited, with only a small but significant increase observed in a 70-year follow-up of Hiroshima and Nagasaki A-bomb survivors, underlining ongoing scientific debate. Through a rigorous selection process, 67 relevant articles / reports covering the period from 1982 to 2024 were selected from databases like PubMed, Scopus, and Web of Science after screening titles and abstracts and evaluating full-text articles meeting inclusion criteria. Advancements in digital radiography, mammography, fluoroscopy, and interventional radiology have reshaped imaging techniques. Traditional methods, augmented by digital tools and algorithms, helps optimize radiation exposure and image quality. Innovations such as ultra-low-dose imaging in mammography aim to enhance cancer detection with reduced radiation. Optimization in fluoroscopy and interventional radiology involves a sophisticated strategy, considering both equipment protocols and operator behavior. Collaboration between medical physicists and optimization teams aligns protocols with equipment functionality. ISO-defined quality management principles guide the establishment of quality in radiology departments through components like quality control and assurance. Dosimetry helps monitor equipment performance and help estimate individualized radiation dose, ensuring patient safety. Medical physicists might lead the development and supervision of performance indicators, helping in the evaluation of departmental performance.. Collaborative initiatives and emerging technologies, including artificial intelligence, reinforce the ongoing journey of dose optimization in radiology. These strategies will shape the future of radiological imaging, enabling personalized patient care and advancing the understanding of health and disease. Haut du formulaire
Keywords: optimization / radiology / certified medical physicist / radiation dose / quality
1 Introduction
Ensuring accurate disease diagnosis and enhancing patient treatment are essential components of healthcare. Over the past five decades, technological advancements have transformed medical imaging, particularly the use of ionizing radiation. This shift from analog to digital, including multidetector-row CT and advanced panoramic and cone beam CT technologies, has expanded imaging services beyond traditional radiology,
* Corresponding author: sekkat. isss @ uhp. ac. ma permeating various clinical specialties. However, access to imaging services remains unbalanced across countries, with the cutting-edge imaging modalities present only in the major metropolitan medical institutions( ICRP, 2010; IAEA, 2015).
The increased adoption of medical imaging has led to a rise in utilization trends. The 2008 UNSCEAR report highlights this trend, particularly due to the increased use of CT( UNSCEAR, 2008). However, the use of ionizing radiation carries a cancer risk, necessitating strict safety standards. The IAEA emphasizes optimization in radiation protection, aiming to keep patient exposure to the minimum necessary for diagnostic or interventional purposes( IAEA, 2014, 2018).
This is an Open Access article distributed under the terms of the Creative Commons Attribution License( https:// creativecommons. org / licenses / by / 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.