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A dose of sophistication comes to CT protocols

by John R. Fischer, Senior Reporter | October 22, 2018
CT X-Ray
From the October 2018 issue of HealthCare Business News magazine


“Maybe the patient was very large, or needed to have a repeat exam because they moved, or perhaps your staff members inadvertently selected the wrong technical factors. That’s what you need to check periodically to make sure your patients aren’t becoming erroneously irradiated,” said Nancy Merrill, director of accreditation for MR/CT/Carotid stenting at the IAC.

As technology improves, CT scanners are able
to generate better images with less radiation.
Further guidance can be found through programs such as Image Wisely, which provides resources and information on ionizing radiation exposure from medical equipment to radiologists, medical physicists, other imaging practitioners and patients; or Image Gently, which supplies guidance for effective and safe imaging of pediatric patients.

Tools such as the American College of Radiology’s Dose Index Registry are also available. Using the ACR registry, clinicians can compare the range and output of their dose index data to that of their peers and similar facilities throughout the country and in their individual regions, and learn and adopt measures to meet quality and safety requirements.
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“The latest technology always comes with a great cost, one that not all facilities can afford,” Debapriya Sengupta, manager of national radiology data registry analytics at the ACR, said. “Dose Index Registry provides high-value but low-cost tools so that all facilities can provide high-quality patient care and meet their Leapfrog reporting requirements.”

While important, dose management and safety is just one area that must be assessed when exposing patients to radiation from CT and other imaging modalities. Clinicians must ask themselves if CT is the correct modality of choice or if there is another that exposes a patient to less or no radiation at all. Furthermore, they must question their own practices in utilizing CT and how those influence the outcomes of procedures and the overall health of patients.

To scan or not to scan
CT utilization has dropped in the past ten years by roughly 20 percent for Medicare beneficiaries, with heightened attention to dose practices playing an integral role. This change in attitude toward dosage is derived from greater emphasis on the appropriate use of CT with clinicians questioning and communicating with one another more often on whether CT is the right option or if another diagnostic tool would be a better option.

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