Justification of Medical Exposures to Ionizing Radiation

Abstract

The increasing use of radiological examinations involving ionizing radiation raises concerns regarding their clinical justification, particularly in light of the projected rise in cancers associated with such procedures. The primary objective of this study was to assess the adequacy of the clinical context field in radiological exam requests, in accordance with the recommendations outlined in the “Manual de Boas Práticas de Radiologia” and Law 108/2018, which establishes the principle of justification for medical exposures.

A cross-sectional analytical observational study was conducted within a “Unidade Local de Saúde”, encompassing three hospital facilities. The sample consisted of 400 exam requests randomly selected in 2025 and reviewed by two Radiation Protection Officers. The requests were classified using the RI-RADS system, which evaluates the quality of the clinical information provided.

Results showed that only 4% of the requests were classified as RI-RADS A (adequate), while 68% were deemed deficient (RI-RADS D). A statistically significant association was found between the quality of the request and both the imaging modality and the origin of the prescription, with the poorest results observed in plain radiography and in the emergency service.

The study concludes that there is an urgent need to improve the prescription process by promoting professional training and revising request templates. The implementation of corrective measures may contribute to a safer and more effective radiological practice, aligned with best practice standards, ensuring better patient care and a more rational use of healthcare resources.