Background: In Germany, approximately 95% of man-made radiation exposure of the population results from diagnostic and interventional X‑ray procedures. Thus, radiation protection of patients in this field of application is of great importance.
Objective: Quantification and evaluation of current data on the frequency and doses of X‑ray procedures as well as temporal trends for the years 2007-2014.
Material and methods: For outpatients the frequency of X‑ray procedures was estimated using reimbursement data from health insurances and for inpatients by means of hospital statistics. For the years under review, representative values for the effective dose per X‑ray application were determined mainly from data reported by X‑ray departments to the competent authorities.
Results: In 2014 approximately 140 million X‑ray procedures were performed in Germany with some 40% from dental examinations. On average 1.7 procedures per inhabitant and year were almost constantly carried out between 2007 and 2014. Besides dental diagnostics, X‑ray examinations of the skeleton and thorax were performed most frequently. The number of computed tomography (CT) examinations increased by approximately 40%. The increase in magnetic resonance imaging (MRI) was even more pronounced with approximately 55% but overall CT examinations were still performed more often than MRI. The doses per X‑ray procedure were only slightly reduced, despite the various dose reduction approaches established in recent years; therefore, the mean effective dose per inhabitant increased from approximately 1.4 mSv in 2007 to 1.6 mSv in 2014, mainly due to the increasing frequency of CT examinations.
Conclusion: The principles of justification and optimization of radiological procedures are to be consistently applied in each individual instance, especially in the case of CT examinations.
Keywords: CT frequency; Dose reduction; Effective dose; Medical radiation exposure; Population dose.