Radiological examinations: justification practice for medical referrers

Is my patient aware of the risks associated with a CT scan? Does the radiological examination offer added value to the diagnosis? A practical guidance document helps those prescribing radiological examinations to choose the right examination, thereby enhancing patient safety.

The Heads of the European Radiological Protection Competent Authorities (HERCA) have relaunched the European communication campaign to raise awareness of the appropriate use of medical radiological examinations.

The campaign was originally launched in November 2019, but its impact was limited due to the subsequent outbreak of the SARS-CoV-2 virus. In light of new insights from the EU-JUST-CT project and renewed momentum around imaging justification, HERCA has decided to relaunch the initiative with broader participation and a renewed focus.

By promoting the appropriate use of medical imaging, HERCA and its member states aim to enhance radiation protection and improve the quality of healthcare.

The importance of justification

By relaunching this campaign, the FOPH aims to highlight the central importance of the justification principle in medical radiation protection. Available data show that some radiological examinations could be avoided or replaced with non-ionising alternatives. The FOPH’s role is to support healthcare professionals in clinical decision-making by providing reliable and harmonised resources at the European level. The objective is clear: strengthen patient safety, promote the appropriate use of imaging, and encourage prescribers to systematically integrate justification into their daily practice.

Getting the right image for my patient

A toolkit for referrers

The campaign stages a consultation situation between referrer and patient. It sets out 7 key questions the referrer should ask when referring for an imgaing examination. It highlights what is in the interest of the patient, along with some simple reflections and arguments that can be readily put forward during the consultation.

To help you request the most appropriate diagnostic imaging for your patients, here are answers to the following questions:

• If I have already made a diagnosis, what is the added value of a radiological examination?

  If the clinical examination has provided you with sufficient information for your diagnosis, a radiological examination may not be necessary.

  • HERCA Leaflet EN1

    PDF165.70 kB20 October 2019

• Should my patient have another radiological examination if one has been done recently?

  If the images you need already exist, it is likely that no value will be added by repeating them.

  • HERCA Leaflet EN2

    PDF146.37 kB20 October 2019

• Should I refer my patient for an X-ray or CT if another examination can be done that does not use ionising radiation?

  If a non-ionising imaging examination can give the best answer to the clinical question, requesting it would save your patient from unnecessary exposure to ionising radiation.

  • HERCA Leaflet EN3

    PDF148.13 kB20 October 2019

• Is my patient aware that a CT is not without risk?

  CT is one of the imaging techniques that delivers the largest quantity of ionizing radiation.

  • HERCA Leaflet EN4

    PDF166.25 kB20 October 2019

• How can I ensure that my patient receives the most appropriate imaging examination?

  Providing all relevant clinical information in your referral will help the radiologist to decide the appropriate examination.

  • HERCA Leaflet EN5

    PDF151.89 kB20 October 2019

• Why is it important to ask if pregnancy is a possibility?

  Special precautions are required for some pregnant patients.

  • HERCA Leaflet EN6

    PDF147.09 kB20 October 2019

• What should I consider before referring a child for an imaging examination?

  Children are more senstitive to ionising radiation due to their growing tissues and their loner lifespan.

  • HERCA Leaflet EN7

    PDF141.29 kB20 October 2019

Further information

• Links

  HERCA : Heads of the European Radiological protection Competent Authorities

  EU-Just-CT EuroSafe Project

  HERCA Press release 2025

• Documents

  • HERCA Main Flyer EN

    PDF283.73 kB21 October 2019

  • Press release

    PDF241.77 kB8 November 2019