There has been an increase in public awareness around patient radiation exposure, due to media attention as well as the widely-promoted Image Gently® and
Image Wisely® campaigns. Several states passed legislation requiring tracking of radiation dose and recently the Joint Commission released new requirements for monitoring and recording patient exposure.
The National Electrical Manufacturers Association's Medical Imaging & Technology Alliance (MITA) continues its dose reduction effort with the approval of MITA Smart Dose, a standard that offers healthcare providers an additional tool to optimize and manage dose in CT scanning.
Developing an effective dose management program takes time, resources and perseverance. There may be significant technical and cultural challenges to surmount. Among the range of issues to be considered:
- Are adult protocols being used on pediatric patients?
- Do my pediatric scans meet Image Gently recommendations?
- What scans are most frequently performed in the ED and what is the typical dose?
- How accurately are technologists centering patients in the CT?
- Is iterative reconstruction software being used appropriately in place of higher dose protocols?
- Do CT studies reflect ACR and AAPM dose guidelines?
- Is there a "frequently flyer" problem with CT scans in the ED?
- How do doses on older systems compare with newer scanners - do we need to upgrade?
- What size and age of patient are we typically imaging? Does the dose scale appropriately?
- How do we ensure identification of all sentinel event or reportable CV/IR studies?
- Are CT protocols using mA modulation to appropriately adjust dose and improve image quality?