J Korean Med Assoc.  2024 Oct;67(10):649-655. 10.5124/jkma.2024.67.10.649.

Clinical imaging guidelines: current status and challenges

• Jang HY
• Choi CH

• KMID: 2560529
• DOI: http://doi.org/10.5124/jkma.2024.67.10.649

Abstract

Background
Advances in medical technology and health insurance coverage policies have significantly promoted radiological examinations in Korea. In 2019, the number of computed tomography examinations performed in Korea was approximately 1.5-times higher than the Organisation for Economic Co-operation and Development average. This surge in radiological examinations has raised concerns regarding inappropriate imaging practices that may lead to unnecessary radiation exposure and increased healthcare cost.
Current Concepts
Two fundamental principles guide the radiation safety practices in medicine: Optimization and justification. Optimization, represented by the “As Low As Reasonably Achievable” principle, minimizes the radiation dose while maintaining the diagnostic quality. Justification ensures that the benefits of radiological procedures outweigh their potential risks. Evidence-based clinical imaging guidelines, such as the UK iRefer guidelines and USA American College of Radiology Appropriateness Criteria, have been internationally proposed to implement these principles. In Korea, collaborative efforts between the National Evidence-based Healthcare Collaborating Agency and Korean Society of Radiology have led to the development of Korean evidence-based clinical imaging guidelines.
Discussion and Conclusion
Implementation of evidence-based imaging guidelines is crucial to reduce unnecessary radiation exposure and optimize resource utilization. However, various challenges, including the adaptation of the guidelines to individual patient needs and successful integration of rapidly advancing medical technologies, remain. Continuous updates, professional education, and system-wide support are essential to ensure the effective implementation of these guidelines. Future studies should focus on enhancing the precision and applicability of these guidelines in clinical practice to improve the patient safety and healthcare efficiency.

Keyword

Clinical imaging guideline; Radiation protection; Justification; Computed tomography; 임상진료지침; 방사선방어; 정당화; 컴퓨터단층촬영