Computed tomography: between diagnostic indispensability and the imperative need for clinical justification

Abstract

Computed tomography (CT) is one of the imaging modalities that has most transformed medical practice since its clinical introduction in 1971. Its ability to generate high-resolution, three-dimensional images has revolutionized the diagnosis of cerebrovascular, oncological, and trauma pathologies, particularly in emergency settings where time is critical. However, the widespread and sometimes indiscriminate use of this technology has generated growing concern regarding the risks associated with exposure to ionizing radiation, especially in the pediatric population. The recent EPI-CT study, published in 2023, confirms a dose-dependent association between CT radiation and the risk of hematological cancers in young people, estimating that for every 10,000 children examined, one or two will develop blood cancer within the next 12 years. This opinion piece argues that, while CT is indispensable in modern medicine, its prescription must be rigorously regulated by strict criteria of clinical justification and dose optimization, avoiding "defensive" use motivated by intolerance of diagnostic uncertainty. Continuing medical education in radiation protection principles and the establishment of technology appropriation protocols are ethical imperatives to maximize diagnostic benefit while minimizing radiological risks.