Medical Imaging Safety in Global Health Radiology

Attention to matters of safety is important in any imaging facility. In the context of low- and middle-income countries, limited resources may complicate the attempt to set up and operate an imaging facility with the highest standards of safety, but it is important to see that all applicable safety measures are nonetheless carried out. Imaging safety involves several general principles, including the need to minimize radiation exposure consistent with answering the clinical question at hand. Safety considerations relevant to patients, staff, and the general public must be addressed. Considerations specific to individual modalities include appropriate limitations on exposure in x-ray and CT imaging, attention to magnetic field hazards in magnetic resonance imaging, proper preparation and control of radionuclides in nuclear medicine, and avoidance of excessive prenatal imaging procedures with ultrasound. An important general safety consideration for all imaging modalities is assuring proper clinical utilization, which includes factors such as not performing imaging procedures without medical referral and supervision, attention to image quality to ensure procedures are not repeated unnecessarily, and carefully considering the clinical appropriateness of any requested imaging procedure. Training and credentialing of staff is of utmost importance, and includes staff who design, prepare, and evaluate a new imaging facility as well as medical staff who acquire, order, or review images. Ensuring imaging safety requires the input of a team of experts, including trained and qualified medical physicists, health physicists, radiation safety officers, clinical safety personnel, installation and service personnel, radiologic technologists, and radiologists. With appropriate attention to safety, diagnostic imaging is a useful component of healthcare services in resource-limited regions.