cancer radiation Archives - The Imaging Wire

With patient safety top of mind these days, radiology professionals are correct to focus on performing CT scans with less radiation. To that end, three recently published research studies highlight new protocols to do just that.

Radiation safety has been one of the top radiology stories in 2025 following several studies underscoring the links between medical radiation and cancer.

The irony is that patient radiation exposure can be reduced dramatically using protocols that already exist – it’s just a matter of applying them consistently in the real world.

In the first paper, published in European Journal of Radiology, researchers share their MINDS-CAD protocol for coronary CT angiography.

MINDS-CAD relies on tailoring contrast dose to patient weight and CT scanner tube voltage using a five-step process.

MINDS-CAD was tested with 112 obese patients getting clinically indicated CCTA with Siemens Healthineers’ Somatom Force dual-source CT scanner and Bayer’s Ultravist 370 contrast agent. Researchers found that compared to a conventional tube voltage-adapted protocol, MINDS-CAD…

Achieved superior image quality according to cases rated “good” or “excellent” (86% vs. 75%).
Generated fewer poor-quality scans (3.5% vs. 8.8%).
Produced sharply lower radiation dose (99 vs. 386 mGy•cm).
Saw no link between vascular attenuation and BMI or tube voltage.

In a second EJR paper, researchers from India tested the ability of an AI-based reconstruction algorithm to reduce dose in cerebral CTA exams.

They used Philips’ Precise Image AI-based reconstruction protocol, which produces images resembling traditional filtered back projection scans while reducing noise like advanced iterative reconstruction methods.

In tests with 68 patients who got cerebral CTA at 100 kVp, compared to iterative reconstruction, Precise Image…

Improved contrast-to-noise ratio 26%, signal-to-noise ratio 22%, and visual noise 16%.
Generated higher image quality scores from radiologists.
Generated an extremely low median effective dose of 0.785 mSv.

Finally, a third study – this one in Clinical Radiology – used a “double low” technique of low-energy 50 keV images on GE HealthCare’s Revolution Apex dual-energy CT scanner with TrueFidelity deep learning image reconstruction on 60 patients with cirrhotic liver disease.

Compared with a conventional protocol, the double-low technique had 48% lower radiation entrance dose (4.10 vs. 7.88 mSv) and 32% lower contrast dose (67.3 vs. 99.1 mL), while image quality was rated higher.

The Takeaway

Taken together, the new papers show that radiology’s radiation dose challenge is eminently solvable thanks to the ingenuity of clinicians and researchers who are pioneering new ways to scan.

A new study revisits the debate over CT radiation risk, finding a link between greater use of CT scanning in a country and the percentage of patients getting higher cumulative doses of radiation over time.

Managing medical radiation has been a priority for decades, but the issue gained new prominence in April with the publication of a controversial paper linking CT use to future cancers.

Critics accused study authors of sensationalizing the radiation dose issue, but researchers pointed out that they used existing models for radiation dose and cancer risk.

Enter the new study, in which a team led by international radiation safety expert Madan Rehani, PhD, calculated the number of patients getting over 100 mSv of cumulative radiation dose over five years across 27 countries, mostly in Europe.

Radiation at such levels is concerning due to the established dose-response nature of current radiation theory – that is, higher doses are believed to lead to higher cancer risk.

Radiation dose exposure rates for CT, fluoroscopy-guided interventions, and PET were analyzed for 2022 for 513M people from Austria to the U.K., with a particular focus on patients getting over 100 mSv in a five-year period.

For point of reference, a chest X-ray PA view is typically 0.02 mSv, a CT scan 1-10 mSv, and the average for a year of background radiation is about 3 mSv.

Researchers found …

In all, 0.27% of the population received cumulative radiation exposure over 100 mSv.
The countries with the highest rates of patients per 1k getting over 100 mSv included Belgium (4.52), Portugal (4.48), Luxembourg (4.19), and France (4.15).
These same countries also tended to have the highest use rates of CT exams per 1k population, led by Portugal (285), Luxembourg (249), Belgium (226), and France (224).
Countries with the lowest exposure rates over 100 mSv included Finland (1.09), Romania (1.1), Norway (1.64), and Bulgaria (1.76), and all had CT use rates below 100 exams per 1k population.

While the U.S. was not included in the study, other research shows it might fall at the upper end of the scale – if not at the top.

The Takeaway

The new study offers a sobering take on the radiation dose issue. While reasonable people can debate the exact link between low-level radiation exposure and cancer risk, it’s harder to justify such wide variation in CT use and cumulative radiation exposure between countries, especially those at similar levels of economic development.

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