Quantifying radiation safety and quality in medical imaging, part 1: creating the infrastructure.

An integral part of cost-benefit analysis within medicine is the comparative assessment of the clinical gains introduced by a service or application compared with the patient costs, which can be measured in economic or clinical terms. When analyzing medical imaging, a number of factors must be included, the most important of which include issues pertaining to patient safety, image quality, and clinical outcomes. Although ionizing radiation has long been recognized as a potential carcinogen capable of introducing harm to patients, the long-term derived benefits have been accepted because of the diagnostic and therapeutic benefits derived from its use. With the increased utilization of high-dose ionizing radiation examinations (such as multidetector computed tomography), it is essential that the medical community create data-driven methodologies to quantify risk in objective terms, develop community-wide radiation standards and "best practice" guidelines (evidence-based medicine), develop new technologies and applications to proactively minimize radiation dose while maintaining quality, and create accountability measures for all pertinent stakeholders.