Under the law, HIQA must justify new and existing practices that expose patients to ionising radiation, as well as medical radiological procedures performed in screening programmes. Justification means making sure that the benefits outweigh the risks involved.

Hospitals and service providers in the public and private sectors who wish to provide a new type or class of practice involving ionising radiation or a medical radiological procedure as part of a screening programme in Ireland must apply to HIQA for justification before the practice or procedure is generally adopted.

We also publish guidelines on the specific justification of medical radiological procedures on asymptomatic individuals, performed for the early detection of disease but not as part of a health screening programme.

Watch our webinar recording about the generic justification of medical exposures to ionising radiation to learn more.

Download slides from our webinar on generic justification (PDF).

HIQA must justify:

  • any new practices that involve exposing patients to ionising radiation before they are generally adopted
  • existing practices that involve exposing patients to ionising radiation, if new and important information becomes available about the efficacy or safety of the practice itself or about any alternative practice that could replace i
  • medical radiological procedures to be performed as part of a health screening programme prior to the commencement of the screening programme.

* ‘generally adopted’ means the practice is used for broad categories of patients, rather than individual patients. The process whereby HIQA approves a practice for a broad category of patients is also known as ‘generic justification’.

To inform a decision to justify a practice or procedure, we carry out a review of related evidence, including clinical effectiveness and safety. 

Our Expert Advisory Group provides advice on each practice or procedure. The Expert Advisory Group provides recommendations on the justification of new practices and medical radiological procedures to HIQA’s Director of Health Technology Assessment. 

More information is available in our Methods for Generic Justification of New Practices in Ionising Radiation document. 

Download Methods for Generic Justification of New Practices in Ionising Radiation (PDF). 

Hospitals and service providers must apply for generic justification or specific justification

To apply for the generic justification of a new type or class of practice, or the specific justification of a medical radiological procedure, a completed application form must be submitted to us. 

If you have any queries about generic justification or specific justification of a medical radiological procedure, please email radiationjustification@hiqa.ie or phone (021) 240 9300.

We have an Expert Advisory Group (EAG) made up of patient and public representatives as well as representatives from regulators and key professional bodies. The EAG reviews the available evidence about practices and medical radiological procedures and makes a recommendation to HIQA about whether the practices or procedures should be justified. 

Any applications for generic justification or specific justification currently in progress are listed below

We publish reports on all decisions on justification of practices involving medical exposure to ionising radiation.

View all generic justification and specific justification decisions (opens new tab).

Following consideration of the evidence and the recommendation of its Medical Exposure to Ionising Radiation Expert Advisory Group, HIQA has issued decisions with respect to the following types and classes of practice:

PracticeDecisionDate Effective
¹⁷⁷Lu oxodotreotide for the treatment of metastatic or inoperable gastroenteropancreatic neuroendocrine tumours (GEP-NETs)Generically justified20 April 2023
A slot-scanning, biplanar, digital X-ray imaging system for the evaluation and monitoring of orthopaedic conditionsGenerically justified10 July 2023
Ultra-hypofractionated adjuvant radiotherapy for breast cancerGenerically justified 16 November 2023
¹⁸F-prostate-specific membrane antigen (PSMA) PET/CT imaging for the staging of high-risk or recurrent prostate cancerGenerically justified 15 December 2023
¹⁷⁷Lutetium PSMA radioligand therapy for the treatment of metastatic castrate-resistant prostate cancerGenerically justified 18 April 2024
Magnetic resonance-guided radiotherapy (MRgRT) for patients with cancer requiring external beam radiotherapyGenerically justified16 June 2025

We have developed guidelines on the use of medical radiological procedures in asymptomatic individuals

We have developed guidelines for justifying medical radiological procedures for the early detection of disease in people who have no known disease or symptoms and not as part of a health screening programme. Justification means making sure that the benefits outweigh the risks involved.

These guidelines apply to any person or organisation conducting medical radiological procedures. This includes individual professionals involved in the provision of medical radiological procedures in dental and medical settings.

The guidelines were developed following the completion of a scoping review and engaging with relevant stakeholders. We held a webinar on these guidelines in January 2026.

View the Guidelines for the justification of medical radiological procedures on asymptomatic individuals, as well as supporting documents such as a scoping review and stakeholder involvement report below. 

  • Generic Justification Application Form

    Download

  • Specific Justification Application Form

    Download

  • Methods for Generic Justification

    Download

  • Asymptomatic guidelines

    Download