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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


Ensuring patients are calm and prepared is part of scan preparation, one of two components (scan preparation and scan performance) according to Frush that determine the success of a CT scan. Movement and improper positioning can degrade quality and diagnostic information, and if extreme, may necessitate re-scanning with additional radiation exposure.

Errors such as incorrect positioning in the gantry, improper arm or leg positioning, or not immobilizing a young patient (when needed) can contribute to overexposure and stress the need for providers to develop and implement comprehensive protocols that are mindful of preparation for children throughout their practices.

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“Without adequate preparation, you may have detriments to scan quality and that means the dose you use is connected to a scan of reduced quality, less ‘bang for the buck’,” said Frush. “In pediatric radiology, and I think likewise for adult radiology, it is important to look at the fundamental basics of scanning, such as preparation, because this increases study quality, potentially reducing patient dose while provide better diagnostic yield.”

Part of dose optimization means knowing when a CT scan
is truly advisable versus when other diagnostics might be better.
In conjunction with correct technique is the other component, technology, which continues to evolve through research and development, such as with the release of a new detector or the discovery of a faster scanning method for decreasing motion. One example is the wider availability over the last few years of dual energy CT technology, which enables clinicians to gather information from a single phase alone and to preclude pre-contrast and post-contrast study.

Another is the incorporation of automated technical factors in scanners that enable radiologic technologists to prep for exams more accurately and avoid exposing the patient to excessive amounts of dose.

Many payors require that such features be assessed as part of the accreditation process to ensure their use equates to safe dose rate applications. “That includes specific technical factors such as your kV, mA or mA range, rotation speed, and pitch – that are very specific items to ensure they are appropriate, with an acceptable radiation dose,” said Merrill.

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