Monday, November 2017 (ESR, Vienna/Zagreb) – The ESR co-organised an IAEA regional workshop on justification and appropriate use of imaging in Zagreb from October 26-28. Part of an ongoing collaboration on issues of common interest with IAEA, the workshop, led by the IAEA's Radiation Protection of Patients Unit (RPOP), allowed the ESR to present its work on justification, imaging referral guidelines and clinical decision support to radiologists and officials from 18 European countries.

The workshop served as a forum for radiologists and representatives from regulatory and health authorities to exchange information on challenges and solutions for improving justification and the utilisation of diagnostic imaging, in the context of implementing the EURATOM basic safety standards directive (mandatory in EU member states from February 2018) and the international basic safety standards for radiation protection and safety of radiation sources, published in 2014.

Under the umbrella of EuroSafe imaging the ESR offers guidance, educational materials and various tools to its individual and institutional members to promote best practice and help them meet the requirements of European legislation and international guidelines on radiation protection.

Among the issues most commonly cited are the availability and accessibility of evidence-based and up-to-date referral guidelines in clinical practice to aid referrers and practitioners in the justification process. The ESR considers referral guidelines for medical imaging essential for improving appropriateness and justification of radiological procedures.

To address gaps in the availability of imaging referral guidelines and the lack of guideline use in Europe, the ESR has developed ESR iGuide, a clinical decision support (CDS) system for European imaging referral guidelines, in cooperation with the American College of Radiology (ACR) and National Decision Support Company (NDSC). Embedding European referral guidelines in a CDS system providing actionable recommendations at the point of care is the most effective way to ensure imaging is used appropriately, and studies have shown that the implementation of CDS and guidelines leads to a reduction in unnecessary radiation exposure.

"The ESR is very supportive of regional workshops and with our large pool of experts we are happy to be involved in future events. For improving justification by using guidelines, the problem is not availability but those guidelines hardly being used for lack of incentives and user-friendly tools. Education is crucial to solving this problem, with a lot of room for improvement in the field of justification. ESR iGuide and EuroSafe Imaging's open access materials are the ESR's solution to make imaging referral guidelines readily available and easily usable everywhere in Europe," summarised Prof. Boris Brkljacic, 2nd ESR Vice-President and local host of the workshop, the society's efforts.

The collaboration between the two organisations will continue later this year in Vienna with the ESR being a cooperating organisation for the IAEA's International Conference on Radiation Protection in Medicine: Achieving Change in Practice (December 11-15).

X-Ray Homepage