Modern principles of the radiation protection from sources of ionizing radiation in medicine. Part 1: Trends, structure of x-ray diagnostics and doses from medical exposure

Implementation of modern highly informative methods of X-ray diagnostics (computed tomography, interventional examinations, nuclear medicine), associated with the increase of doses to the public and patients, requires the development and improvement of the existing system of the radiation protection from medical exposure. Despite the prevalence of the traditional imaging modalities in the structure of X-ray diagnostics in the Russian Federation (radiography and fluorography compose up to 95% out of 280 mln. X-ray examinations performed in 2017), the major contribution into the collective dose from medical exposure is due to the computed tomography (50,5%). Comparison of the structure of X-ray diagnostics in the Russian Federation with European Union indicates the absence of fluorography examinations and significantly (up to a factor of 5) higher contribution of computed tomography in European countries. An average collective dose from medical exposure in European countries is composed of 80% of computed tomography and of 10% of nuclear medicine; a mean effective dose per X-ray examination are higher up to a factor of 3 compared to Russia. The analysis of the trends of the development of the X-ray diagnostic in the Russian Federation allows predicting a further increase of the number of computer tomography, interventional and nuclear medicine examinations as well as an increase of the collective dose from medical exposure up to a factor of two in the  next decade. This will be associated with changes in the structure of the X-ray diagnostics and an increase of the mean effective doses from X-ray examinations.

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