Abstract

The topic of CT radiation dose management is receiving renewed attention following the recent approval by CMS for new CT dose measures. Widespread variation in CT dose persists in practices across the world, suggesting that current dose optimization techniques are lacking. This article outlines a proposed strategy for facilitating global CT radiation dose optimization. CT radiation dose optimization can be defined as the routine use of CT scan parameters that consistently produce images just above the minimum threshold of acceptable image quality for a given clinical indication and accounting for relevant patient characteristics using the most dose-efficient techniques available on the scanner. To accomplish this, an image quality-based target dose must be established for every protocol; for non-head CT applications, these target dose values must be expressed as a function of patient size. As variation in outcomes is reduced, the dose targets can be decreased to more closely approximate the minimum image quality threshold. Maintaining CT radiation dose optimization requires a process control program, including measurement, evaluation, feedback, and control. This is best accomplished by local teams, made up of radiologists, medical physicists, and technologists, supported with protected time and needed tools, including analytics and protocol management applications. Other stakeholders critical to facilitating CT radiation dose management include researchers, funding agencies, industry, regulators, accreditors, payers, and the American College of Radiology. Analogous coordinated approaches have transformed quality in other industries and can be the mechanism for achieving the universal goal of CT radiation dose optimization.

View details for DOI 10.1016/j.jacr.2024.01.014

View details for PubMedID 38302037