In clinical routine, different imaging tasks require different levels of quality: Images of the highest quality are not essential for all diagnostic tasks. Instead, the level of image quality needed (e.g. good low-contrast discernibility at low noise levels, or high spatial resolution accepting an increased noise level) is dependent on the clinical task, i.e. it should be based on the indication as well as on the individual patient characteristics [2]. For imaging modalities relying on the use of ionizing radiation such as computed tomography (CT),...

Main Task: Identification of an indication-based set of adequate standardized criteria for judging the “appropriateness” of image quality for a certain CT imaging task Current Activities & Ongoing Work: Composition of a group of experts from within the network of organ-based subspecialty societies of radiology (currently CIRSE, ESGAR, ESPR, ESSR, and ESTI) and experts from EFRS, from one of the largest European diagnostic service providers, as well as from ESR’s Radiation Protection Subcommittee Information exchange with the EuroSafe Imaging Subgroup on Clinical Diagnostic Reference Levels...

Conclusion: The level of image quality that is deemed “appropriate” for answering a particular clinical question with high diagnostic accuracy and confidence needs to be specific for each clinical indication. ‘Appropriateness’ of the image quality of diagnostic procedures should therefore only depend on clinical indication, while theoretically being independent of factors such as patient characteristics or the imaging hard- and software used for the examination. For imaging modalities relying on the use of ionizing radiation, e.g. CT, achieving “appropriate image quality” for a particular examination...

Dr. Wolfram Stiller is a physicist at the University Hospital Heidelberg, Germany, dedicated to research in the field of x-ray computed tomography imaging. He is a member of the ESR Radiation Protection Subcommittee as well as of the EuroSafe Imaging Steering Committee. This EPOS was submitted on behalf of the EuroSafe Imaging Appropriate Image Quality Subgroup.

[1] European Association of Nuclear Medicine (EANM), the European Federation of Organizations for Medical Physics (EFOMP), the European Federation of Radiographer Societies (EFRS), the European Society of Radiology (ESR), and the European Society for Radiotherapy and Oncology (ESTRO). “Common strategic research agenda for radiation protection in medicine.” Insights Imaging, 2017. doi: 10.1007/s13244-016-0538-x. [2] International Commission on Radiation Protection (ICRP). “Managing patient dose in multi-detector computed tomography (MDCT). ICRP Publication 102.” Annals of the ICRP, Vol. 7, No. 1, March 2007, pp.: 1-79. [3] International Commission...