Quantifying benefit and detriment in radiology

Colin Kotre

Quantifying benefit and detriment in radiology

Colin Kotre

Faculty of Health Central

Research output: Contribution to conference › Poster › peer-review

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Abstract

Background: Under UK law, before a medical exposure can take place, a documented decision has to be made by the IR(ME)R Practitioner that the benefit will exceed the risk. So does the Practitioner actually know whether it does or not? Although they might diligently follow all of the guidance in place, it is unreasonable to expect proof that an anticipated medical benefit exceeds the probabilistic future cancer risk from a medical radiation exposure when the two are not only not in the same units, but are entirely different concepts.

Method: The established bodies of work on effective dose carried out by the International Commission on Radiological Protection, and on disability-adjusted life years (DALY) carried out by the World Health Organisation are combined to explore a route to quantitative justification of medical radiation exposure in terms of benefit.

Results: With the application of a suitable model, the rate of change of the lifetime DALY detriment with age at acute exposure to 1 Sv of ionising radiation can be used to derive a dose-dependent DALY disability weight. This can be compared with the many DALY disability weights for disease states and injuries which might be diagnosed by radiology to produce a quantitative estimate of the ratio of benefit to detriment.

Conclusion: Analysis of over 70 types of radiological examination shows the medical benefit to exceed the radiation detriment in every case. The result essentially highlights the progress of optimisation in radiology.

References:
Kotre C J 2024. Increasing the public awareness of justification. J. Radiol. Prot. 44 013501 https://doi.org/10.1088/1361-6498/ad1cd5
Kotre C J 2023. Comparing benefit and detriment from medical diagnostic radiation exposure using disability-adjusted life years: towards quantitative justification J. Radiol. Prot. 43 041512 https://doi.org/10.1088/1361-6498/ad1159
Kotre C J 2025. Definition of a disability weight for human exposure to ionising radiation and its application to the justification of medical exposure BJR Open https://doi.org/10.1093/bjro/tzae043

[Poster abstract no. P059]

Original language	English
Publication status	Published - 2 Jun 2025
Event	UK Imaging and Oncology Congress - ACC Liverpool, Liverpool, United Kingdom Duration: 2 Jun 2025 → 4 Jun 2025 https://www.ukio.org.uk/programme-2025/

Conference

Conference	UK Imaging and Oncology Congress
Abbreviated title	UKIO 2025
Country/Territory	United Kingdom
City	Liverpool
Period	2/06/25 → 4/06/25
Internet address	https://www.ukio.org.uk/programme-2025/

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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title = "Quantifying benefit and detriment in radiology",

abstract = "Background: Under UK law, before a medical exposure can take place, a documented decision has to be made by the IR(ME)R Practitioner that the benefit will exceed the risk. So does the Practitioner actually know whether it does or not? Although they might diligently follow all of the guidance in place, it is unreasonable to expect proof that an anticipated medical benefit exceeds the probabilistic future cancer risk from a medical radiation exposure when the two are not only not in the same units, but are entirely different concepts. Method: The established bodies of work on effective dose carried out by the International Commission on Radiological Protection, and on disability-adjusted life years (DALY) carried out by the World Health Organisation are combined to explore a route to quantitative justification of medical radiation exposure in terms of benefit. Results: With the application of a suitable model, the rate of change of the lifetime DALY detriment with age at acute exposure to 1 Sv of ionising radiation can be used to derive a dose-dependent DALY disability weight. This can be compared with the many DALY disability weights for disease states and injuries which might be diagnosed by radiology to produce a quantitative estimate of the ratio of benefit to detriment. Conclusion: Analysis of over 70 types of radiological examination shows the medical benefit to exceed the radiation detriment in every case. The result essentially highlights the progress of optimisation in radiology. References: Kotre C J 2024. Increasing the public awareness of justification. J. Radiol. Prot. 44 013501 https://doi.org/10.1088/1361-6498/ad1cd5 Kotre C J 2023. Comparing benefit and detriment from medical diagnostic radiation exposure using disability-adjusted life years: towards quantitative justification J. Radiol. Prot. 43 041512 https://doi.org/10.1088/1361-6498/ad1159 Kotre C J 2025. Definition of a disability weight for human exposure to ionising radiation and its application to the justification of medical exposure BJR Open https://doi.org/10.1093/bjro/tzae043 [Poster abstract no. P059]",

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N2 - Background: Under UK law, before a medical exposure can take place, a documented decision has to be made by the IR(ME)R Practitioner that the benefit will exceed the risk. So does the Practitioner actually know whether it does or not? Although they might diligently follow all of the guidance in place, it is unreasonable to expect proof that an anticipated medical benefit exceeds the probabilistic future cancer risk from a medical radiation exposure when the two are not only not in the same units, but are entirely different concepts. Method: The established bodies of work on effective dose carried out by the International Commission on Radiological Protection, and on disability-adjusted life years (DALY) carried out by the World Health Organisation are combined to explore a route to quantitative justification of medical radiation exposure in terms of benefit. Results: With the application of a suitable model, the rate of change of the lifetime DALY detriment with age at acute exposure to 1 Sv of ionising radiation can be used to derive a dose-dependent DALY disability weight. This can be compared with the many DALY disability weights for disease states and injuries which might be diagnosed by radiology to produce a quantitative estimate of the ratio of benefit to detriment. Conclusion: Analysis of over 70 types of radiological examination shows the medical benefit to exceed the radiation detriment in every case. The result essentially highlights the progress of optimisation in radiology. References: Kotre C J 2024. Increasing the public awareness of justification. J. Radiol. Prot. 44 013501 https://doi.org/10.1088/1361-6498/ad1cd5 Kotre C J 2023. Comparing benefit and detriment from medical diagnostic radiation exposure using disability-adjusted life years: towards quantitative justification J. Radiol. Prot. 43 041512 https://doi.org/10.1088/1361-6498/ad1159 Kotre C J 2025. Definition of a disability weight for human exposure to ionising radiation and its application to the justification of medical exposure BJR Open https://doi.org/10.1093/bjro/tzae043 [Poster abstract no. P059]

AB - Background: Under UK law, before a medical exposure can take place, a documented decision has to be made by the IR(ME)R Practitioner that the benefit will exceed the risk. So does the Practitioner actually know whether it does or not? Although they might diligently follow all of the guidance in place, it is unreasonable to expect proof that an anticipated medical benefit exceeds the probabilistic future cancer risk from a medical radiation exposure when the two are not only not in the same units, but are entirely different concepts. Method: The established bodies of work on effective dose carried out by the International Commission on Radiological Protection, and on disability-adjusted life years (DALY) carried out by the World Health Organisation are combined to explore a route to quantitative justification of medical radiation exposure in terms of benefit. Results: With the application of a suitable model, the rate of change of the lifetime DALY detriment with age at acute exposure to 1 Sv of ionising radiation can be used to derive a dose-dependent DALY disability weight. This can be compared with the many DALY disability weights for disease states and injuries which might be diagnosed by radiology to produce a quantitative estimate of the ratio of benefit to detriment. Conclusion: Analysis of over 70 types of radiological examination shows the medical benefit to exceed the radiation detriment in every case. The result essentially highlights the progress of optimisation in radiology. References: Kotre C J 2024. Increasing the public awareness of justification. J. Radiol. Prot. 44 013501 https://doi.org/10.1088/1361-6498/ad1cd5 Kotre C J 2023. Comparing benefit and detriment from medical diagnostic radiation exposure using disability-adjusted life years: towards quantitative justification J. Radiol. Prot. 43 041512 https://doi.org/10.1088/1361-6498/ad1159 Kotre C J 2025. Definition of a disability weight for human exposure to ionising radiation and its application to the justification of medical exposure BJR Open https://doi.org/10.1093/bjro/tzae043 [Poster abstract no. P059]

M3 - Poster

T2 - UK Imaging and Oncology Congress

Y2 - 2 June 2025 through 4 June 2025

ER -

Quantifying benefit and detriment in radiology

Abstract

Conference

UN SDGs

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