Diagnostic Radiology, 20 Footes Lane, Morristown, NJ 07960, USA.
Health Phys. 2011 Nov;101(5):562-5. doi: 10.1097/HP.0b013e3182259a71.
X-rays were discovered by Wilhelm Röntgen in 1895. Within one year, benefits of x-rays, such as visualization of fractures, and detriments, such as x-ray dermatitis, were recognized. Nobel Laureates Pierre and Marie Sklodowska Curie discovered the radioactive element radium in 1898, and a year later the application of radiation to cure cancer was reported. A significant price was paid for this: Marie Curie died of aplastic anemia related to her radiation exposure, and her daughter Irene Joliot Curie, Nobelist for radiochemical research, died of radiation-induced leukemia. Internationally developed radiation protection recommendations were formalized starting in the late 1920s. The increasing use of ionizing radiation in medical diagnosis and radiation therapy has brought significant societal benefits. Known risks of therapeutic radiation include coronary artery disease and secondary malignancy. However, recently concerns have been raised of possible very small but incremental increases in malignancies due to diagnostic medical radiation. Patients are largely unaware of, and referring physicians and even radiologists often underestimate, the carcinogenic effects of radiation. There is a need to determine the appropriateness of imaging tests that use ionizing radiation prior to performance; optimize imaging protocols to reduce unnecessary radiation; include patients in the decision process and encourage and enable them to track their radiation exposure; and promote education about medical radiation to patients, referring physicians, radiologists, and members of the public. The basic radiation protection principles of justification, optimization, and application of dose limits still pertain.
X 射线是由威廉·伦琴于 1895 年发现的。在不到一年的时间里，人们就认识到了 X 射线的好处，如骨折的可视化，以及它的危害，如 X 射线皮炎。1898 年，诺贝尔物理学奖得主皮埃尔和玛丽·居里夫妇发现了放射性元素镭，次年就有报道称辐射可用于治疗癌症。为此付出了巨大的代价：玛丽·居里因辐射暴露导致再生障碍性贫血而去世，她的女儿艾琳·约里奥-居里因辐射引起的白血病而去世，后者是放射化学研究的诺贝尔奖获得者。从 20 世纪 20 年代末开始，国际上制定了辐射防护建议。电离辐射在医学诊断和放射治疗中的应用越来越广泛，带来了巨大的社会效益。已知治疗性辐射的风险包括冠心病和继发性恶性肿瘤。然而，最近人们对由于诊断性医疗辐射可能导致的非常小但逐渐增加的恶性肿瘤的风险提出了担忧。患者对此大多不知情，而转诊医生甚至放射科医生往往低估了辐射的致癌作用。有必要在进行之前确定使用电离辐射的成像检查是否合适；优化成像方案以减少不必要的辐射；让患者参与决策过程，并鼓励和帮助他们跟踪自己的辐射暴露情况；向患者、转诊医生、放射科医生和公众宣传有关医疗辐射的知识。正当化、最优化和剂量限值应用的基本辐射防护原则仍然适用。
