Surveying standards: Study finds many unaware of CT dose standards

Despite National Electrical Manufacturers Association (NEMA) CT Dose Check standards being available for almost two years, a recent study has found that almost half of participating organizations were not familiar with them.

The research was led by Donald L. Miller, MD, of the FDA’s Center for Devices and Radiological Health in Silver Spring, Md., and published this month by the Journal of the American College of Radiology.

In 2010, NEMA published the CT Dose Check standards and in the following year, the American Association of Physicists in Medicine (AAPM) published its recommendations for use of the NEMA standards.

“The NEMA CT Dose Check standard was an outgrowth of the lessons learned during the FDA’s investigation of the anomalously high radiation exposures during certain brain perfusion studies that were first reported in September 2009,” Miller and colleagues wrote. The authors stated that it was hoped the standards would be adopted industry wide.

Miller and colleagues set out to study how successfully the dosing standards had been adopted by sending surveys to 460 facilities that participated in the American College of Radiology Dose Index Registry. A total of 170 facilities responded to the survey.

Results showed that as of June 2013, two years after the AAPM recommendations were published, only 57 percent of respondents were aware of the NEMA standard, and only 51 percent of respondents were aware of the AAPM recommendations for Notification Values and Alert Values.

Study authors cite one reason for the lack of standards adoption might stem from a facility’s lack of equipment with technology capable of implementing the dosing alerts and standards. According to respondents, fewer than half (44 percent) of facilities had at least one CT scanner with Dose Check capability.

“Another impediment to adoption may be the confusion regarding the details of Dose Check and the recommendations for numerical values,” the authors wrote.

Because the standards and alerts ensure patient safety and provider protection, the authors encourage a campaign of facility and staff education of the dosing standards adopted in 2011.

“Facilities should be encouraged to incorporate Dose Check into daily practice,” Miller and colleagues wrote.