HERCA held a workshop on "How to inspect justification and optimization in diagnostic radiology" on 6-8 October 2015 in Brussels, Belgium.

The workshop brought together inspectors, mainly from Europe, to exchange practical ideas and experiences when it comes to inspection of justification and optimization. From discussions in working groups, the participants produced recommendations and identified good practices on practical aspects of these inspections in the field of diagnostic radiology.


Justification and optimization are two of the fundamental principles of radiation protection and must be carried out for each individual exposure as per the new European radiation protection directive (Council Directive 2013/59/Euratom). Regulatory bodies have an important role in promoting and ensuring that the principles of justification and optimization are properly implemented at medical imaging facilities. Therefore, inspections to verify local implementation of these principles are an important task for regulatory bodies. The goal of HERCA includes facilitating the development of training programmes and providing opportunities to share experiences. This will enable inspectors to gain sufficient competence for issuing advice and influencing justification and optimization processes for medical exposures.

Workshop objectives

To disseminate and harmonize good inspector practices across Europe and to identify areas for improvement. Furthermore, to discuss how onsite inspections can be used to check compliance and to encourage implementation of justification and optimization processes in diagnostic radiology to ensure proper use of medical exposure locally at medical imaging facilities. The workshop covered diagnostic radiology only. Patient and occupational exposure was addressed.

A significant part of the programme was devoted to discussions within working groups to enable the participants to share good practices. From the discussions, the participants produced recommendations on how to inspect justification and optimization processes in diagnostic radiology.


Practical Information

Workshop Programme

Workshop Presentation

Workshop Presentations

Session 1 – Opening remarks and setting the scene (Chair: Eva G. Friberg)


Opening Remarks and setting the scene – Eva G. Friberg, Norway

Session 2 – Regulatory framework and responsibilities (Chair: Jürgen Griebel)

Regulatory framework and inspections in a perfect world – Steve Ebdon-Jackson, UK

Regulatory framework and inspections in Southern Europe – Marina Sanchez, Spain

Regulatory framework and inspections in Eastern Europe - Petr Papirnik, Czech Republic

Regulatory framework and inspections in Northern Europe – Carole Rousse, France

Session 3 – Ways to inspect and how effective they are (Chair: Eva G. Friberg)

From measurements (QC of equipment) to review of QA-system – Torsten Cederlund, Sweden

Model for graded approached and risk based inspections – Torsten Cederlund, Sweden

How to inspect in a clinical environment – Steve Ebdon-Jackson, UK

Session 4 – Inspector competence (Chair: Maria Kalathaki)

How to train inspectors – the UK program – Steve Ebdon-Jackson, UK

Inspector exchange - Nordic experience – Carl Bladh-Johansson, Sweden

European education program for inspectors - Hilde Bosmans, Belgium

Session 5 –Approaches for inspecting justification and optimization (Chair: Richard Elek)

Things to consider when inspecting justification – Lodewijk Van Bladel, Belgium

Things to consider when inspecting optimization – Eva G. Friberg, Norway

Inspection of Cardiology departments: A success history – Reidun Silkoset, Norway

Session 7 – How to inspect justification

How to inspect justification – Eva G. Friberg, Norway

Session 8 – How to inspect optimization

How to inspect optimization – Eva G. Friberg, Norway

Session 9 – Results from working groups


Justification results WG1

Justification results WG2

Justification results WG3

Justification results WG4


Optimisation results WG1

Optimisation results WG2

Optimisation results WG3

Optimisation results WG4

Session 10 – Summary and closing remarks of the workshop

Summary and closing remarks – Eva G. Friberg, Norway