X-rays in medicine are used to see images of bones and other structures in the body. Several years of research have been conducted to determine the benefits of X-rays and their risks. Although classified as a carcinogen by WHO because it can increase the risk of cancer, several studies reveal a minimal risk when compared with the benefits of medical imaging it produces so that until now the use of x-rays is still widely practiced. X-ray scanning is also still a safer choice than surgery. The use of X-rays helps non-invasively and painlessly to diagnose disease and monitor therapy, support medical and surgical treatment planning, guide medical personnel when inserting catheters, stents, or other devices in the body. In this article you will know the procedures, benefits, and risks of using X-rays to find out the answer, are X rays safe?
X-rays are a form of electromagnetic radiation that occurs naturally and is produced when sufficient energy-charged particles, crashing into the material. Imaging using X-rays is a painless fast test procedure that produces images of structures inside your body especially the bones. The X-rays that pass through the body are absorbed in different amounts depending on the density of the material they pass. The image will appear in shades of black and white when X-rays pass through the body. The resulting image of X-rays can reveal signs of illness and injury.
The bones and metal will appear white on the X-rays, while the air in your lungs appears black, whereas muscle fat looks like a grey color as it absorbs less radiation. If you have pneumonia or lung tumor, they will appear as more white spots on the X-ray film because they are denser than the air-filled areas in the lungs.
During the X-ray procedure, you must remain silent so that the resulting image is not blurred. This procedure usually takes only a few minutes and if necessary it will be taken more than one X-rays taken from different angles to provide as much information as possible. You should also bite on a piece of the film if you do X-rays on the tooth.
X-ray procedures are performed by the radiographer from behind the scenes or from the next room. During X-rays, it is recommended to wear loose clothing and do not wear jewelry, glasses, and any metal objects as they may appear in the results of the output. You should wear comfortable loose clothing.
After the X-ray procedure, you can do normal activities immediately as there are no side effects. The result of the image will be sent to the radiologist to read, then sent to the Doctor who takes care of you. This process usually takes a day or more depending on how many patients are served in the hospital.
Type of medical imaging using X-rays
There are many types of medical imaging that use X-rays that each have different benefits. Some types of medical imaging include computed tomography (CT), fluoroscopy, mammography, and radiography. CT examination, radiography, and fluoroscopy using X-rays passed through the body where some of the X-rays are absorbed or propagated by the internal structure, and the remaining X-ray pattern is transmitted to the detector (for example, film or computer screen) to record or further process by the computer.
The computed tomography (CT) examination uses an X-ray with the help of a computer to re-contract all individual images into a cross-sectional image or slice of internal organs and tissues. CT examination uses the greatest X-ray dose when compared to other X-ray procedures such as radiography and fluoroscopy. CT Scan tests provide more detailed images including 3D images, such as bones, soft tissues, blood vessels, and internal organs.
X-ray procedures called radiography result in image footage to be evaluated. Radiography is best used for both bone and solid tissue imaging. The mammography procedure is a specific type of radiography to describe the internal structure of the breast. This examination usually detects the presence and development of breast cancer.
Another X-ray procedure is a fluoroscopy that uses X-rays and a neon screen to study the moving or real-time structures in the body such as, viewing heart rate. Fluoroscopy inspection allows real-time monitoring of a procedure or part of a contrasting substance (dye) through the body.
Fluoroscopy can also be used to view the digestive process, blood flow, and guide the placement of the instrument precisely in certain locations within the body, such as joint aspiration or during epidural injections. The procedure of fluoroscopy can produce a relatively high dose of radiation when used for complex interventional procedures and requires fluoroscopy for a long time (placing a stent or other device in the body).
Some types of X-ray tests use contrast media in the form of liquids such as iodine or barium that are inserted into your body to provide greater detail to the image. If routine procedures only take a few minutes, but the use of a contrast agent will make the procedure an hour or more. Barium swallow to help highlight the upper digestive system, whereas barium enema is passed to your intestines through the bottom. Iodine is injected into the blood vessels to highlight the kidneys, heart, and bladder.
The use of this contrast medium in some people can cause side effects such as mild headache, itching, nausea, vomiting, constipation, hoarseness noises, rapid heartbeat, confusion, stomach ulcers, diarrhea, and a warm or flushed feeling. After X-rays, you can resume normal activities, but if you receive contrast media, we recommend drinking plenty of fluids to help eliminate the side effects.
X-rays are an important part of the diagnostic process and have been used in medicine for a very long time. X-Ray technology has far greater benefits than the potential negative consequences of its use. X-rays can help diagnose medical problems and monitor the progression of treatment without having to conduct patient screening through surgery.
The use of X-rays often gets unexpected findings, which are different pathology of the initial reason for imaging. For example, some types of tumors and infections of bones, gases, or liquids in areas that should not exist. X-rays can also help guide medical professionals when they include catheters, stents and other devices in the patient.
X-rays can be used to detect fractures and infections that most cases occur in bones and teeth. The use of X-rays in the bones can also measure bone density and reveal bone tumors. X-rays can also be used to see abnormal curvature of the spine (scoliosis). X-rays can take pictures of teeth, jaws, and examine dental problems (perforated teeth, loose teeth, and tooth abscesses).
X-rays can also be used to examine the breast tissue to see breast cancer commonly referred to as mammography. X-rays can not only be used to see cancer but can also be used for the treatment of cancer. X-rays with high doses and radiation can help destroy cancer cells and tumors by damaging their DNA.
X-rays are often used by cardiologists to guide during certain procedures, e.g. during coronary angioplasty, which is the procedure for widening the narrowed arteries near the heart. Its X-rays are used to help guide the catheter along one of your arteries. X-rays can also be used to see a variety of heart problems such as heart failure, enlarged heart, and blocked blood vessels. Signs of heart failure and changes in blood flow to the lungs and heart will be evident in the chest X-rays.
Chest X-rays can also be used to look at infections or lung conditions as well as lung problems, such as pneumonia, tuberculosis, and lung cancer. X-rays can also reveal signs of arthritis so that the doctor can determine if your arthritis deteriorates. X-rays can also find out the problem of the gastrointestinal tract and foreign objects such as items swallowed by children.
Risk of using X-rays
After knowing the benefits of using X-rays, you also need to know the risks of using X-rays for health. All types of X-ray examinations use ionizing radiation to produce intact images that can potentially cause DNA damage and can increase a person’s lifetime risk of cancer.
X-rays that hit atoms will produce ions, which are atoms that have an electrical charge that can cause unnatural chemical reactions in cells. One of these chemical reactions can break the DNA chain, causing DNA damage or mutations. The more cells the body dies, the body can develop various diseases. If DNA mutates, cells can become cancerous which can easily spread throughout the body. DNA mutations that occur in eggs or sperm can cause birth defects.
Large doses of ionizing radiation can increase the risk of tissue damage, genetic disorders, or cancer that may develop decades after exposure to radiation. According to the American Cancer Society, radiation not only occurs when we carry out examination procedures that use X-rays but also occurs from radiation emitted from natural sources such as radon (natural gas) and cosmic rays from space and the sun.
X-rays are categorized as carcinogens by WHO because they can cause DNA mutations that cause cancer. Research shows the use of X-rays in patients with age 75 years will increase the risk of cancer by 0.6 percent to 1.8 percent. This shows the risk of using X-rays is very minimal when compared with the benefits of medical imaging it produces.
Besides being associated with an increased risk of cancer, X-rays have a very low risk of short-term side effects. The lower dose of radiation produced by X-rays, it is increasingly believed that X-rays do not cause direct health problems. Exposure to high radiation levels is very avoided because it can have various effects such as vomiting, bleeding, hair loss, and fainting.
The level of radiation produced by X-rays depends on the part of the body that is imaged. Children are more susceptible to the effects of X-ray radioactivity than adults. CT scans in children can triple the risk of brain cancer and leukemia, especially when given to the stomach and chest at certain doses.
The highest radiation level was found in the abdominal CT, head CT, and upper gastrointestinal examination. CT and interventional procedures such as angiography and cardiac catheterization are associated with higher radiation doses, around 100 to 1000 times more than chest X-rays.
The following is a list of radiation doses received based on the part of the body imaged. This comparison is done with the amount of natural radiation that a person receives every day from various sources. Natural radiation can come from the sun, from the earth, even from some chemicals in our bodies, all of which you cannot avoid.
|Type of test||The amount of radiation received|
|Stomach CT||Equivalent to 2.7 years |
of natural radiation received
|Upper gastrointestinal |
|Equivalent to 2 years |
of natural radiation received
|Urogram IV||Equivalent to 1 year |
of natural radiation received
|CT head||Equivalent to 243 days |
of natural radiation received
|Lumbar spine||Equivalent to 182 days |
of natural radiation received
|X-ray of the skull||Equivalent to 12 days |
of natural radiation received
|Chest radiograph||Equivalent to 2.4 days |
of natural radiation received
Information about a patient’s pregnancy is very important for the doctor to know to avoid potential risks in the developing child when selecting drugs. This also applies to examinations that use radiation. The unborn baby grows faster and is more susceptible to radiation than adults. If you need an X-ray of the stomach during pregnancy, be sure to talk to your doctor even though the chances of harm to the unborn baby are very small.
Most X-ray examinations do not have serious risks to the unborn baby, but the risk of complications is always present on X-ray examinations in a pregnant woman. Examination of the abdomen and pelvis in pregnant women usually uses ultrasonography (USG). Ultrasonography is used to monitor the fetus and not use X-rays so it is safer for pregnancy. X-rays are usually not recommended for pregnant women except in emergencies such as using ultrasound does not answer questions about your health problems. The choice of type and method of imaging examination will be carefully chosen to minimize the amount of radiation exposure in infants.
The use of X-rays for airport security scanners is often feared by many people about the effects of radiation on health. The radiation dose from the x-ray body scanner at the airport is very small and is equivalent to about one hour of natural background radiation. Some scans at airports do not use X-rays so they do not cause radiation. Alternative terahertz scanners use radio wave frequencies. The Joint Report from the British Institute of Radiology and the Royal College of Radiologists (2011) provides more details on the use of airport security scanners.
Various risks due to radiation exposure from X-rays above, X-ray scanning is still a safer choice than surgery. X-ray equipment must also be maintained by qualified staff and regularly tested. X-ray machines are still a very valuable tool in medicine and are truly one of the most useful inventions of all time.
Are x-rays safe?
To answer this question, we have known the various benefits of using X-rays for medical needs and various possible health risks. The more scans you do, the higher your lifetime exposure and therefore the higher your risk. Although there is no practical evidence of the effects of low radiation exposure from human studies to date, theoretical possibilities cannot be ruled out.
The benefits of clinical X-rays generally far outweigh the risks. The average CT scan can increase the likelihood of cancer by 1 compared to 2,000, meaning that compared to the natural occurrence of fatal cancer in the US 1 to 5. In the report of the American Journal of Clinical Oncology states that X-ray procedures carry no risk. This report argues that the type of radiation in the scan is not enough to cause long-term damage. Reports suggest that damage caused by low-dose radiation is repaired by the body without leaving a lasting mutation.
Permanent damage can be generated only when a certain threshold is reached. The threshold is generally much higher than the X-ray dose of all types of scanning. Some threshold recommendations, such as from the American College Radiology, limit lifetime radiation exposure to 100 mSv which is equivalent to 10,000 chest radiographs or 25 chest CT. A threshold of 10,000 chest x-rays is almost impossible for a person to live in his lifetime, so this makes the risk considered too small to cause cancer when the part of your body being examined is only exposed to low levels of radiation, for a fraction of a second.
When the risk of radiation exposure is far less than the medical imaging benefits obtained by patients, the effort we can do is to minimize the use of unnecessary X-ray radiation and only use it when they are really needed. If medically necessary, medical imaging tests, including x-rays, are safe for children and pregnancy. Medical imaging for children who are more sensitive to radiation usually uses special pediatric techniques to ensure the lowest radiation dose for your child, and each test is read by a certified radiation expert.
According to research, the American Heart Association found that radiation from standard X-rays in children is low enough so that it does not increase the lifetime risk of cancer for children. Radiologists will also calibrate the settings to the appropriate level of radiation for children, reduce potential risks and prevent excessive radiation exposure in children.
Special techniques in medical imaging for pregnant women are also needed. It also aims to minimize radiation exposure to unborn babies because they are considered more sensitive than adults. Generally, the dose for an unborn child will be very low because the patient’s pelvic area is not exposed to X-rays. The radiologist will take special steps to protect the uterus and its surroundings with a lead apron if an X-ray is really needed during pregnancy. The doctor may delay the procedure that will place the pelvic area and the unborn child in the direct path of X-rays.
The delay of medical imaging using X-rays can also be done more selectively on patients who will have X-rays such as, x-rays of the breast (mammography). Currently, mammographic examinations are only done on those who have symptoms of breast cancer, or those who have menopause, or those who have a personal or family history of breast cancer.
If necessary to consider alternative examinations that use less or no radiation exposure, such as MRI or ultrasound, if medically appropriate. The doctor must also check the patient’s medical imaging history to avoid double examination.
Alternative medical imaging
If you still doubt the safety of using X-rays, then you need to look for other alternative examinations that do not use X-rays. Generally, the doctor will consider the medical history, examination, other test results, and radiation dose when deciding on the investigation method. If possible, doctors can choose alternative tests that do not expose the patient to radiation.
Other alternative examinations that do not use X-rays are ultrasonography and magnetic resonance imaging (MRI). Ultrasonography is used to examine the pelvis and abdomen during pregnancy, and for the breast, testes and soft tissues of the neck. Ultrasonography is also best used to see soft tissues such as muscles, internal organs, and blood flow in real-time. Ultrasound uses high-frequency sound waves to create images and does not use X-rays (radiation).
MRI provides extraordinary details of soft tissue in the body. MRI is often used to scan the head, joints, and spine. MRI also does not use X-rays, so there is no risk of radiation. MRI produces detailed images using strong magnetic fields, radiofrequency pulses, and computers.
What the next
X-rays may increase the chances of cancer later on, but the amount of radiation used in X-ray examinations is generally very small so the possibility of X-rays will cause this problem is very low. X-ray radiation also has almost no risk of side effects on your child’s health. However, it makes sense to avoid unnecessary risks, no matter how small by avoiding X-rays that are not medically necessary. Most importantly, X-rays can help detect disease or injury at an early stage so that the disease can be treated appropriately.
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