World imaging leaders share 7 strategies to optimize CT dosage

Recently, radiology leaders from around the world engaged in discussions to help create a framework for radiation safety by developing strategies for CT dose optimization. 

“Advances in medical imaging with CT have led to widespread availability and use of CT imaging to improve healthcare,” corresponding author Robin R. Whitebird, PhD, with the University of St Thomas, Morrison Family College of Health, and co-authors explained. “Although there is agreement that imaging doses should be as low as reasonably achievable, widespread variation remains in clinical practice across facilities for similar procedures.” 

By speaking with radiology leaders from around the globe, the authors of the study sought to consolidate strategies from a diverse group of organizations to provide a foundation for CT dose optimization based on methods others have already successfully employed. 

Through their interviews with 26 leaders (including radiologists, medical physicists, CT technologists and operational managers) from healthcare systems across the U.S., Europe and Japan, they were able to single out seven strategies organizations can implement to optimize CT doses

The strategies are listed below:

  1. Engaging radiologists and technologists: Discussing issues and proposed changes with a designated radiologist and CT technologist (typically the lead tech) should be a priority, according to 81% of participants. Any changes should be discussed thoroughly between the two parties and then communicated to those working alongside them. 

  1. Creating a CT dose committee: Establishing a structured, diverse and inclusive group is vital for implementing changes, with 73% of participants noting its importance. Many suggested that their committee was the driving factor behind reviews, setting goals and developing protocols. 

  1. Managing organizational change: Clear and concise communication was a prevalent theme among respondents, with it being discussed by 65%. This can be achieved by establishing a clear communication route and keeping everyone involved in talks, according to the leaders. Staff education was also highly regarded. 

  1. Leadership and support: This included providing resources and “man hours” to do the necessary work, as well as striving for more than a “lukewarm leadership buy-in” so as to keep staff engaged and motivated.

  1. Monitoring and Benchmarking: Use dose data to drive change and create benchmarks to strive for. This can provide a clearer picture of where the focus should be in terms of creating and altering protocols, experts suggested. 

  1. Modifying CT protocols: Some suggested “harmonizing” protocols to limit variations and avoid confusion. Several reported that their protocols were locked until everyone agreed to modify them. 

  1. Equipment and work rule changes: Although equipment is expensive, newer technology is efficient in optimizing CT doses and a worthwhile investment, the authors suggested. The work rules participants cited most often pertained to developing departmental procedures and protocols and making them available via manuals.

You can view the detailed strategies in the Journal of the American College of Radiology

More on radiation dose reduction techniques:

Deep learning image reconstruction decreases radiation dose 43% on coronary CTA scans

ACR releases new benchmarks to help radiology departments optimize radiation dose levels

Deep learning-based reconstruction reduces pediatric CT dose by 54%, maintains image quality

Low-dose CT scans just as accurate as standard for diagnosing appendicitis

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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.

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