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This publication reports on the outcome of an IAEA coordinated research project and addresses the important issue of radiation dose management during the transition from analogue to digital radiology. While the radiation dose needed to obtain image quality similar to conventional imaging is lower, the latitude of the digital systems also allows much higher doses to be delivered without being detected. Recommendations on how to ensure that the benefit to be gained from this technology will not be outweighed by radiation risk are discussed in detail. The findings described in this publication will help both the medical community and the equipment manufacturers/suppliers make their respective contributions to dose reduction and thus optimize radiological protection of patients undergoing medical exposure.