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• Clinical decision support systems for imaging referral provide generic justification for the clinical situation, but personal justification is needed particularly when dose is high or when the patient is sensitive to the effects of radiation. • Strategies to address cumulative high doses include stronger justification between radiologists and referrers; guidance for the frequency of surveillance procedures; and the drive to reduce CT doses through innovation in industry.

Cumulative radiation dose from multiple CT examinations: stronger justification, fewer repeats, or dose reduction technology needed?