Radiation hygiene in medical X-ray imaging

The frequency of X-ray examinations in Germany and the resulting radiation exposure is amongst the highest in comparison with other European countries. To reduce medical radiation exposure and to safeguard radiation protection regulations, the X-ray ordinance stipulates a justification of each individual X-ray application. The justification principle means that the X-ray application should produce sufficient health benefit to offset the radiation risk. Such a benefit-risk assessment needs an adequate estimation of radiation risk. The aim of this paper is to explain the principles of benefit-risk assessment for different situations (e.g. healthcare and screening). The basics and concepts of radiation effects and radiation epidemiology as well as examples of risk estimation and benefit-risk assessments are given.