Program Information
Diagnostic Reference Levels and Achievable Doses: Practical Clinical Implementation to Optimize CT Protocols and Dose
K Kanal1*, J Moirano1 , D Zamora1 , P Butler2 , R Morin3 , (1) University of Washington, Seattle, WA, (3) University of Washington, Seattle, WA, (2) American College of Radiology, Reston, VA, (3) Mayo Clinic, Jacksonville, FL
Presentations
TU-RPM-GePD-IT-4 (Tuesday, August 1, 2017) 3:45 PM - 4:15 PM Room: Imaging ePoster Theater
Purpose: To propose practical clinical implementation methods of recently published diagnostic reference levels (DRLs) and Achievable Doses (ADs) for common adult CT exams to optimize protocols and dose
Methods: Diagnostic Reference levels (DRLs) and achievable doses (ADs) for the 10 most common adult CT examinations (stratified by patient size) in the United States using the ACR CT Dose Index Registry (DIR) were recently published. We propose some practical ways they can be clinically applied: 1) using AD values as a starting point for comparison to current practice CT doses; 2) using median dose values from ACR CT DIR (if participating) or local Dose Management System (if available) for comparison to the published AD and DRL; 3) Using published DRL as an action threshold to investigate high dose and review protocol settings; 4) using published AD or some multiple of AD to set as dose threshold when enabling Dose Check on CT scanners; and, 5) preparing a cheat sheet which displays published and institution AD and DRLs for the common CT exams for technologist education.
Results: Since the published DRLs and ADs have become available, we have implemented some of the methods proposed above. Since we do not have patient size data consistently and readily available, we have compared our average ADs and DRLs for our different sites to the published values and found them to agree overall with a few exceptions. These exceptions allow us to focus protocol modification efforts. We have also prepared a summary sheet displaying our doses and the published values for our technologists for active referencing when scanning.
Conclusion: Early implementation of these methods has guided protocol improvement efforts and has helped technologist intuition on dose. Efforts to attain patient size are ongoing.
Contact Email: