Is ALARA met if images stay within recommended exposure index ranges but are always at the high end of the range?

• A. No, the radiographer should aim for the lowest index within range that produces an acceptable image
• B. Yes, staying within recommended index range meets ALARA guidelines
• C. No, the radiographer should always aim for the middle of the index range
• D. Yes, it is best to aim toward the high end of the index range to provide better image resolution

Answer: (A)

ALARA means using the lowest exposure that still yields a diagnostically acceptable image. Even if the exposure index stays within the recommended range, consistently using the high end means the patient is receiving more radiation than necessary without added diagnostic benefit. The goal is to adjust technique so you achieve acceptable image quality with the smallest possible exposure within that range. So, you look for the lowest index that still gives an adequate image rather than always targeting the middle or the high end. Relying on the high end to supposedly improve resolution isn't correct, because increasing exposure does not inherently improve image quality and only increases dose.