Radiation dose reduction in computed tomography: techniques and future perspective

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However, despite the clear evidence that CT provides invaluable information for diagnosis and patient management, a potential risk of radiation-induced malignancy exists [6]. CT alone contributes almost one half of the total radiation exposure from medical use and one quarter of the average radiation exposure per capita in the USA [301]. A series of recent articles used the total radiation dose received by the entire US population from CT to estimate the potentially attributable cancer incidence or mortality in the whole population [5,7,8]. One study suggested that as much as 1.5–2% of cancers may eventually be caused by the radiation dose currently used in CT [5]. These estimates, however, remain highly controversial [9], since the cancer-risk model used in these articles relies on the National Academies of Science’s report on the biological effects of ionizing radiation [6], which notes that the statistical limitations of available data make it difficult to evaluate cancer risk in humans at low doses (<100 mSv), which is a factor of ten to 100 higher than the effective dose from a typical CT examination. More importantly, the benefit to the patient of an appropriately indicated CT scan was not taken into account by these articles, particularly considering that the majority of the total radiation dose from CT to the US population was received by older or symptomatic populations. In these individuals, the health benefit of a timely, accurate and noninvasive diagnosis that CT facilitates far exceeds the estimated potential risk [9].