Chen Juan, Zheng Jianjun, Zhang Qun, Zhang Jingfeng, Dai Qi, Zhang Dandan
Ningbo No. 2 Hospital, Ningbo, China.
Hangzhou Medical College, Hangzhou, China.
Front Public Health. 2025 Jul 18;13:1626906. doi: 10.3389/fpubh.2025.1626906. eCollection 2025.
Medical imaging modalities constitute indispensable diagnostic and therapeutic decision-making tools in contemporary clinical practice. These modalities are pivotal in disease detection, longitudinal monitoring, and treatment response assessment. However, the progressive accumulation of radiation exposure from recurrent imaging procedures has sparked significant clinical concerns regarding potential carcinogenic and non-carcinogenic health implications. This review analyzes the driving factors of recurrent medical imaging examinations, identifies high-risk populations, and evaluates the potential health risks associated with cumulative radiation exposure, aiming to optimize imaging techniques and dose management strategies. By integrating global radiation exposure data (e.g., UNSCEAR reports) and multicenter clinical research evidence combined with a literature review and dosimetry models, the study reveals the high-risk nature of emergency department patients, chronic disease patients, children, and female populations in recurrent imaging. Clinical needs, demographic characteristics, technological misuse, and uneven healthcare resource allocation are identified as key drivers of recurrent imaging. This review further highlights that short-term, high-frequency imaging accelerates cumulative radiation dose accumulation, potentially elevating long-term health risks, while long-term, low-dose exposure is associated with cardiovascular diseases and malignancies. Based on the linear no-threshold (LNT) model and evidence of DNA repair mechanisms, the study proposes individualized risk assessment to optimize imaging intervals and dose modulation techniques to balance diagnostic efficacy and radiation safety. The policy implications of this research include advocating for enhanced radiation safety education and targeted management strategies for high-risk populations and providing empirical support for updating international radiation protection guidelines, thereby facilitating the clinical implementation of the "As Low As Reasonably Achievable" (ALARA) principle.
医学成像模态是当代临床实践中不可或缺的诊断和治疗决策工具。这些模态在疾病检测、长期监测和治疗反应评估中起着关键作用。然而，反复进行成像检查导致的辐射暴露逐渐累积，引发了对潜在致癌和非致癌健康影响的重大临床关注。本综述分析了反复进行医学成像检查的驱动因素，确定了高危人群，并评估了与累积辐射暴露相关的潜在健康风险，旨在优化成像技术和剂量管理策略。通过整合全球辐射暴露数据（如联合国原子辐射效应科学委员会报告）、多中心临床研究证据，并结合文献综述和剂量测定模型，该研究揭示了急诊科患者、慢性病患者、儿童和女性人群在反复成像中的高危性质。临床需求、人口统计学特征、技术滥用和医疗资源分配不均被确定为反复成像的关键驱动因素。本综述进一步强调，短期、高频成像会加速累积辐射剂量的积累，可能增加长期健康风险，而长期、低剂量暴露与心血管疾病和恶性肿瘤有关。基于线性无阈（LNT）模型和DNA修复机制的证据，该研究提出进行个体化风险评估，以优化成像间隔和剂量调制技术，平衡诊断效果和辐射安全性。本研究的政策意义包括倡导加强辐射安全教育和针对高危人群的管理策略，为更新国际辐射防护指南提供实证支持，从而促进“合理尽可能低”（ALARA）原则的临床实施。
