IAEA Releases New Global Guidance to Improve Patient Safety and Quality in Medical Imaging

Despite their growing use in routine clinical practice, guidance on how to set up, evaluate, and ensure the accuracy of these systems has been limited.

The International Atomic Energy Agency (IAEA) has released comprehensive new guidance on dose management systems (DMS) — specialised software tools used to collect, monitor, and analyse patient radiation dose data — aiming to strengthen patient safety and improve the quality of diagnostic imaging worldwide.

The publication, Dose Management Systems: From Setting up to Quality Assurance, is designed to help medical physicists and healthcare professionals better understand, implement, and operate these systems across clinical settings. Since its release in September 2025, the guidance has ranked among the top eight most accessed IAEA publications for that month, reflecting strong global demand.

“Information presented on the content, data analysis and evaluation of these systems will help to advance quality assurance, patient safety and the optimization of medical imaging,” said Virginia Tsapaki, IAEA medical physicist and technical officer responsible for the publication.

What Are Dose Management Systems?

Dose management systems play a critical role in tracking patient-specific radiation exposure from diagnostic imaging procedures, including:

• Computed tomography (CT)

• Mammography

• SPECT-CT

• Positron emission tomography–CT (PET-CT)

By automating the collection, archiving, analysis, and sharing of radiation dose data, DMS reduce manual processes, improve accuracy, and streamline clinical workflows.

These systems are increasingly essential for:

• Meeting regulatory requirements on radiation exposure monitoring

• Optimising radiological procedures

• Assessing radiation doses at both individual and population levels

Despite their growing use in routine clinical practice, guidance on how to set up, evaluate, and ensure the accuracy of these systems has been limited.

“Despite the growing importance of these systems, there has been little guidance on how medical physicists can best set them up and assess their accuracy,” said May Abdel-Wahab, Director of the IAEA Division of Human Health.

Addressing Interoperability and Data Quality Challenges

The IAEA said differences in imaging equipment from multiple manufacturers often create interoperability challenges, complicating system integration and performance evaluation.

Dose management systems also depend heavily on accurate, standardised, and consistent data inputs, adding further complexity when assessing compatibility between hardware and software components.

“In addressing this critical gap, the IAEA has developed dedicated guidance which provides a standardized approach for health professionals to harness these systems safely and effectively,” Abdel-Wahab said.

What the New Guidance Covers

The publication provides end-to-end guidance on the implementation, operation, and optimisation of dose management systems, including:

• Roles and responsibilities of clinical staff within imaging departments

• Key metrics used in dose management systems

• The role of healthcare information systems

• How clinical workflows influence DMS performance

• Technical aspects, from hardware and software architecture to system functionality

• Requirements for efficient system integration in clinical environments

• Quality assurance processes for acceptance testing, commissioning, and routine operation

• Practical challenges, including software upgrades and the addition of new imaging modalities

Through real-world clinical scenarios, the guidance demonstrates how dose management systems can be applied in everyday practice to support safer and more efficient imaging services.

Future Potential: AI and Proactive Decision-Making

The publication also highlights how emerging technologies such as machine learning and artificial intelligence could further enhance dose management systems by improving workflow efficiency, strengthening regulatory compliance, and supporting better patient outcomes.

High-quality data and continuous system improvement are identified as essential to unlocking this potential, with the guidance outlining strategies to strengthen long-term system performance.

“The coming decade will see dose management systems becoming essential infrastructure,” said Ioannis Tsalafoutas, a medical physicist at Hamad Medical Corporation and an expert contributor to the publication.

“They will move from retrospective reporting to proactive support for patient-centred decision-making, automating quality assurance and strengthening protection for every patient.”

Broad International Endorsement

The guidance has been endorsed by a wide range of professional bodies, including:

• American Association of Physicists in Medicine

• International Organization for Medical Physics

• European Federation of Organisations for Medical Physics

• Federation of African Medical Physics Organisations

• Asia–Oceania Federation of Organizations for Medical Physics

• Latin American Medical Physics Association

• International Society of Radiographers and Radiological Technologists

• South East Asian Federation of Organizations for Medical Physics

Looking Ahead: IDOS 2026

Dose management systems and related innovations will be a key focus of the IAEA International Symposium on Standards, Applications and Quality Assurance in Medical Radiation Dosimetry (IDOS 2026), to be held in Vienna from 5 to 9 October 2026.

Medical physicists, radiation metrologists, and researchers working in radiation dosimetry are invited to submit abstracts by 2 April 2026.