Less variability, better patient care: 3 steps to reducing radiation dose in CT exams

As radiology practices and departments throughout the country work to reduce radiation dose during CT examinations, the authors of a new study published in the Journal of the American College of Radiology wrote about the success they found in reducing dose by following three specific steps.

1. Establish a committee to oversee everything

The authors first established a Radiation Dose Optimization Committee, which “became the oversight entity responsible for disseminating protocols and policies.”

“Previously, no formal entity had authority for every site in the network,” wrote lead author Ryan K. Lee, MD, MBA, Einstein Healthcare Network in Philadelphia, and colleagues. “Adherence to these policies was monitored by this committee, which evaluated the dashboards monthly and directly followed up with the CT supervisors at each site. The decreases in variability and dose that gradually occurred during the intervention period were metrics that demonstrated to the committee that these protocols were being followed.”

2. Standardize protocols to reduce variability

The next step was standardizing protocols, which was accomplished by referencing recent literature on the topic and turning to the guidance of various section chiefs and technologists. Getting the protocols in place was important, they noted, but it was also important to get everyone on the same page.

“Employing strategies designed to reduce radiation dose in CT examinations is without question an important component in performing a CT examination,” the authors wrote. “From a quality perspective, however, also important is ensuring consistency and reproducibility of the examinations, and nowhere is this more important than in the delivery of radiation dose.”

(For more Radiology Business coverage of standardizing imaging protocols, click here.)

3. Implement advanced scanner software

“The implementation of software designed specifically to manage radiation dose was also an important component in reducing dose variation across the network,” the authors wrote.

Lee et al. noted that the software reduced variability while also improving “the performance of the scout view itself.”

Overall, the authors saw the average radiation dose for all CT exams improve from 22.3 CTDIvol with an SD of 17.0 from January 2013-July 2014 to 13.6 CTDIvol with an SD of 9.01 from January-December 2016. “A significant decrease in the variability of our network CT radiation doses was achieved through a multifactorial approach that effectively managed radiation dose,” they concluded.