[Patient exposure during radiodiagnosis. The Nationwide Evaluation of X-ray Trends (NEXT) program in Italy].

The aim of this paper is the critical analysis of the results obtained with the quality control program in X-ray diagnosis called NEXT (Nationwide Evaluation of X-ray Trends). It is also aimed at comparing the above results with guidelines and trends of international radiology, for both technical features and patient protection from radiations. The main purpose of patient protection is the reduction of unnecessary exposure through the optimization of radiodiagnostic procedures. In order to identify the fields requiring the application of specific quality control programs, the Istituto Superiore di Sanità, together with ENEA/DISP have been running the NEXT program in Italy since 1977. The program, through data collection and measurements in more than 2,500 radiologic units, allowed both state of the art and progress in radiodiagnostic practice to be studied over a long period of time. Data computation provides, for a standard patient, the skin entrance exposure and the main organ doses for the examinations which are most frequently performed. In this paper, the fundamentals of the NEXT program are reported and the most significant results are discussed, and compared, when possible, with the values recommended by international scientific organizations. The analysis of the results demonstrates a decreasing trend in patient exposure over the last years.