Which practice is not aligned with ALARA principles?

• A. Prolonged fluoroscopy to improve image quality.
• B. Use shielding.
• C. Employ non-fluoroscopic imaging when possible.
• D. Optimize equipment settings.

Answer: (A)

ALARA principles aim to keep radiation exposure as low as reasonably achievable by reducing exposure time, using shielding, and applying dose-saving techniques. Prolonged fluoroscopy to improve image quality directly increases the radiation time, which raises the dose to both patient and staff. This approach conflicts with ALARA because it prioritizes image quality at the expense of exposure reduction.

In contrast, shielding helps protect personnel from scatter, non-fluoroscopic imaging when possible reduces unnecessary radiation, and optimizing equipment settings—such as using pulsed fluoroscopy, appropriate frame rates, collimation, and maintaining optimal distance—reduces dose while preserving usable image quality.