La radiologia medica

, Volume 124, Issue 8, pp 714–720 | Cite as

Overdiagnosis and overimaging: an ethical issue for radiological protection

  • Sergio SalernoEmail author
  • Andrea Laghi
  • Marie-Claire Cantone
  • Paolo Sartori
  • Antonio Pinto
  • Guy Frija


Aims and objectives

This study aimed to analyse the key factors that influence the overimaging using X-ray such as self-referral, defensive medicine and duplicate imaging studies and to emphasize the ethical problem that derives from it.

Materials and methods

In this study, we focused on the more frequent sources of overdiagnosis such as the total-body CT, proposed in the form of screening in both public and private sector, the choice of the most sensitive test for each pathology such as pulmonary embolism, ultrasound investigations mostly of the thyroid and of the prostate and MR examinations, especially of the musculoskeletal system.


The direct follow of overdiagnosis and overimaging is the increase in the risk of contrast media infusion, radiant damage, and costs in the worldwide healthcare system. The theme of the costs of overdiagnosis is strongly related to inappropriate or poorly appropriate imaging examination.


We underline the ethical imperatives of trust and right conduct, because the major ethical problems in radiology emerge in the justification of medical exposures of patients in the practice. A close cooperation and collaboration across all the physicians responsible for patient care in requiring imaging examination is also important, balancing possible ionizing radiation disadvantages and patient benefits in terms of care.


Overimaging Overdiagnosis Ethics Radiation protection 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors but is a review of current clinical cases.

Ethical standards

This article does not contain any studies with animals performed by any of the authors.


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Copyright information

© Italian Society of Medical Radiology 2019

Authors and Affiliations

  1. 1.Department of Diagnostic RadiologyUniversity of PalermoPalermoItaly
  2. 2.Department of Surgical and Medical Sciences and Translational Medicine, Sant’Andrea University HospitalSapienza-University of RomeRomeItaly
  3. 3.Department of Biomedical, Surgical and Dental SciencesUniversity of MilanMilanItaly
  4. 4.Department of RadiologySS Giovanni e Paolo HospitalVeniceItaly
  5. 5.Department of RadiologyCTO HospitalNaplesItaly
  6. 6.Department of Diagnostic Radiology, Hopital Européen Georges Pompidou Paris APHPUniversité Paris-DescartesParisFrance

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