EM · Imaging choice and radiation risk

Imaging choice and radiation risk in the emergency department

Also known as Modality selection · Radiation dose and ALARA · Appropriate imaging · Contrast risk and nephrogenic systemic fibrosis · Imaging in pregnancy · CT versus MRI versus ultrasound · Contrast-associated acute kidney injury · Choosing Wisely imaging

Imaging choice and radiation risk — the structured selection of the modality (X-ray, CT, MRI, ultrasound) that answers the clinical question at the lowest risk, governed by ALARA and the linear-no-threshold model. The effective doses (CXR 0.02 mSv, CT head 2 mSv, CT abdomen 10 mSv against a 2–3 mSv/yr background); the stochastic (cancer) and deterministic (skin erythema, cataract, infertility) effects; the four-modality differential with speed, cost, sensitivity and operator-dependence; the pregnancy pathway (ultrasound first, MRI second, CT last, never withhold a life-saving image on dose alone); the contrast risks — iodinated contrast-associated AKI and gadolinium-associated nephrogenic systemic fibrosis with the group I/II/III agent stratification; the appropriateness criteria and the Choosing Wisely do-not list. ACEM-primary, globally tagged.