Program Information
Quality Improvements in CT Dose Optimization Using the ACR Dose Index Registry
J Moirano*, D Zamora , J Robinson , K Kanal , Univ Washington, Seattle, WA
Presentations
TU-H-CAMPUS-IT-5 (Tuesday, August 1, 2017) 4:30 PM - 5:30 PM Room: Imaging ePoster Theater
Purpose: The American College of Radiology Dose Index Registry (DIR) allow institutions to compare CT radiation dose indices to nationally aggregated data based on exam type and body part. These comparisons allow a site to assess their scan protocols against benchmark data, and drive decisions for optimization. The following describes an approach to quality improvement using these methods at our institution.
Methods: Aggregate data is evaluated semi-annually by a medical physicist. Exam types that fall outside of the DIR interquartile range are selected for further analysis. Scan protocols that comprise the outlier exam types are identified and sorted based on the study description and individual scanner’s protocol naming scheme. The lead technologist is consulted to verify the implementation and classification of the protocols. A radiologist with expertise in the anatomy in question is consulted to provide clinical and image quality guidance. The team discusses the exam protocols with regards to workflow, clinical utility, and scanner parameters and attempts to identify any areas that can be optimized to reduce patient dose without compromising diagnostic quality. Suggested changes are brought to a meeting of stakeholders, or addressed at the CT protocol review committee, where an implementation strategy is discussed.
Results: Exam types with patient doses higher than the 75th percentile have been identified and successfully strategies for patient dose reduction have been implemented. In one case, the median CTDIvol of a study was reduced from 60.29 mGy to 30.44 mGy without affecting clinical usage. Data integrity issues have been identified, such as misclassification of exam type, and improper calculation of dose indices.
Conclusion: The DIR is a powerful tool that allows a department to identify anomalies in their CT protocols. The aggregate data gives an achievable value for dose indices that can be used as a target for optimization.
Contact Email: