A new study in the Journal of the American College of Radiology puts the spotlight on a California facility that has reduced radiation dose by as much as 90 percent for CT examinations.

In 2010, Imaging Healthcare Specialists, a chain of private practice imaging centers in the San Diego, Calif. area, added iterative reconstruction software to dose reduction strategies they already had in place.

"Doing [what I call] 'smart protocols,' we were already lowering the dose by 40 to 50 percent, without spending money. After that we implemented SafeCT," Dr. John Johnson, lead author of the study and a founding partner of Imaging Healthcare Specialists, told DOTmed News.

"We lowered the dose by 90 percent for certain patients who met our criteria, no one has published that kind of data before," said Johnson.

The smart CT protocols that Johnson is referring to are dose adjustments based on each patient's Body Mass Index (BMI), and SafeCT is a universal CT image reconstruction add-on system used to improve the signal to noise ratio of CT images that range in exposure parameters. Johnson said a lot of facilities already use iterative reconstruction or noise reducing software, which can lower dose by about 30 to 40 percent. But in order to achieve greater dose reduction, as highlighted in the study, Johnson said both needed to be implemented.

In addition to iterative reconstruction and Smart CT protocols, Imaging Healthcare Specialists also limited the length of coverage and multiphase examinations on patients.

Johnson points out that some patient scans can't sacrifice being even a little noisy, and in those cases, they don't lower the dose. "But for general evaluation of trauma patients and those with abdominal pain or kidney stones, we are experts and have read hundreds of scans."

Johnson hopes other facilities can learn from their example and that policies like these can become standard practice.

"For not a lot of money and little investment of time, our program is easy to implement. We even give you the cut-offs for BMIs when you turn the dose down. All you have to do is program the scanner," said Johnson.

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