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Updated: Jun 5, 2025

X-ray Dose Reduction through Adaptive Exposure in Fluoroscopic Imaging
Published on: September 11, 2011
Descriptive overview of AI applications in x-ray imaging and radiotherapy
John Damilakis1,2, John Stratakis2
1School of Medicine, University of Crete, Heraklion, Greece.
Abstract:
Artificial intelligence (AI) is transforming medical radiation applications by handling complex data, learning patterns, and making accurate predictions, leading to improved patient outcomes. This article examines the use of AI in optimising radiation doses for x-ray imaging, improving radiotherapy outcomes, and briefly addresses the benefits, challenges, and limitations of AI integration into clinical workflows. In diagnostic radiology, AI plays a pivotal role in optimising radiation exposure, reducing noise, enhancing image contrast, and lowering radiation doses, especially in high-dose procedures like computed tomography (CT). Deep learning (DL)-powered CT reconstruction methods have already been incorporated into clinical routine. Moreover, AI-powered methodologies have been developed to provide real-time, patient-specific radiation dose estimates. These AI-driven tools have the potential to streamline workflows and potentially become integral parts of imaging practices. In radiotherapy, AI's ability to automate and enhance the precision of treatment planning is emphasised. Traditional methods, such as manual contouring, are time-consuming and prone to variability. AI-driven techniques, particularly DL models, are automating the segmentation of organs and tumours, improving the accuracy of radiation delivery, and minimising damage to healthy tissues. Moreover, AI supports adaptive radiotherapy, allowing continuous optimisation of treatment plans based on changes in a patient's anatomy over time, ensuring the highest accuracy in radiation delivery and better therapeutic outcomes. Some of these methods have been validated and integrated into radiation treatment systems, while others are not yet ready for routine clinical use mainly due to challenges in validation, particularly ensuring reliability across diverse patient populations and clinical settings. Despite the potential of AI, there are challenges in fully integrating these technologies into clinical practice. Issues such as data protection, privacy, data quality, model validation, and the need for large and diverse datasets are crucial to ensuring the reliability of AI systems.
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