Balancing precision and safety: the crucial imperative of radiation dose optimization in radiology and the role of certified medical physicists in quality assessment

This review systematically examines the optimization of radiological imaging protocols and practices from December 2023 to April 2024. Through a rigorous selection process, 97 relevant articles and reports were identified from databases like PubMed, Scopus, and Web of Science. Screening of titles and abstracts, followed by a thorough evaluation of full-text articles meeting inclusion criteria, yielded 63 studies for qualitative analysis. Advancements in digital radiography, mammography, fluoroscopy, and interventional radiology have reshaped imaging techniques. Traditional methods, augmented by digital tools and algorithms, optimize imaging while minimizing radiation exposure. Innovations such as ultra-low-dose imaging in mammography aim to enhance cancer detection with reduced radiation. Optimization in fluoroscopy and interventional radiology involves a nuanced approach, considering both equipment protocols and operator behavior. Collaboration between medical physicists and optimization teams aligns protocols with equipment functionality. ISO-defined quality management principles guide the establishment of quality in radiology departments through components like quality control and assurance. Dosimetry monitors equipment performance and estimates individualized radiation risks, ensuring patient safety. Performance indicators help in assessing departmental performance, with medical physicists driving their development and monitoring. Collaborative initiatives and emerging technologies, including artificial intelligence and theranostics, underscore the ongoing journey of dose optimization in radiology. These strategies will shape the future of radiological imaging, enabling personalized patient care and advancing our understanding of health and disease.