Reducing patient radiation exposure up to 90 percent

"In the past decade, there have been unparalleled technological advances and growth in CT imaging, with many lives saved and more costly and invasive procedures avoided. This growth in CT imaging, however, has also been accompanied by an unavoidable increase in cumulative radiation exposure to the public," said John O. Johnson, MD, author of the article.

At Imaging Healthcare Specialists, a highly successful program of radiation dose reduction was created, and dose savings of up to 90 percent have been achieved in select patients.

"Our primary focus was to reduce radiation dose for CT examinations of the chest, abdomen and pelvis because these constitute the most frequent studies in our practice and those with the highest radiation dose. Ultimately, all imaging protocols were revised," said Johnson.

The following dose reduction strategies were developed over months of careful computed tomography (CT) dose adjustment and imaging analysis:

• Decreased Peak Kilovoltage

• Low-dose Automatic Dose Modulation

• Decreased Length of Coverage

• Pitch

• Iterative Reconstruction and Noise Reduction Software

In addition, the imaging facility focused on limiting double scans and multiphase examinations; performing low-dose follow-up CT examinations; and the use of iterative reconstruction and noise reduction software. A low-dose strategy for CT-guided biopsies was also developed.

"To implement such a program requires dedication, leadership and commitment. Key components include a lead CT physician, a lead CT technologist, a CT applications specialist, a continuous feedback loop and systems in place to educate staff members and audit compliance," said Johnson.

"It is possible to perform high-quality CT at a fraction of the radiation dose previously thought possible. Using a combination of dose reduction strategies with or without iterative reconstruction, risks can be minimized, thereby ensuring the health and welfare of our patients," he said.