The Impact of Radiographer Feedback on the Rate of Red Flag Dose Alerts in CT Studies

Congress:

ECR 2019

Poster Number:

C-3757

Type:

Scientific Exhibit

Keywords:

CT, Radioprotection / Radiation dose, Radiation safety, Dosimetric comparison

Authors:

C. Crowley, B. Carey, O. O’Connor; Cork/IE

DOI:

10.26044/ecr2019/C-3757

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-3757

Fig. 1: Dose monitoring software in action

Fig. 3: Workflow of data selection and analysis

Table 1: Red alerts among the five most common study descriptions that triggered alerts

Table 2: Percentage of True Alerts for both study periods for the five main study...

Fig. 4: Causes of false alerts during Period 1 and Period 2

Table 3: Mean dose length products for Period 1 and Period 2

Aims and objectives

The number of CT examinations being performed has grown considerably in recent years. This in turn has led to an increased awareness of the risks of ionizing radiation exposure and the need for justification of the doses administered. CT accounts for the greatest proportion of medical exposure to radiation.1, 2 Dose management software provide real-time monitoring of patient dose in CT examinations.3 Dose tracking software is capable of notifying operators of high doses. These can be issued as a “red alert”. Many of these alerts...

Methods and materials

Dose monitoring software (DoseWatch, General Electric Healthcare, Waukesha WI, USA) was instructed to issue an alert (red alert) if twice the median dose for a particular CT protocol occurred. The average dose for each protocol was automatically calculated by the software. Figure 1 shows an example of the data made available by DoseWatch for a particular CT study. Dose data from a single CT scanner (Discovery 750HD, GE Healthcare) was gathered for an initial 6-month period (Period 1: 31st December 2014 to 30th June 2015)...

Results

Figure 3 shows the workflow of data selection and analysis for Period 1 and Period 2. After introducing the radiographer feedback tool, there was a small increase in the rate of red alerts from 4.7% in Period 1 to 5.1% in Period 2. The five most common study descriptions that resulted in red alerts were the same for both time intervals: CT pulmonary angiograms (CTPA), CT abdomen pelvis (CT ABP), CT thorax abdomen pelvis (CT TAP), CT brain (CTB) and CT thorax (CT Th). The...

Conclusion

The number of red alerts rose after the implementation of a radiographer feedback tool. Even so, the number of true alerts fell by more than half and there was no significant difference in CT radiation doses between the two study periods, with the majority of mean DLPs remaining below NDRLs. Low uptake (17.1%) of the feedback tool by radiographers highlights the challenges of implementing justification strategies into workflow, with time constraints likely having a major influence on this. Radiographer justification was shown to provide reliable...

Personal information

Dr Claire Crowley Department of Radiology, Cork University Hospital, Cork, Ireland. Email: [email protected]

References

1. NCRP-Report-160. Ionizing radiation exposure of the population of the United States. National Council on Radiation Protection and Measurements. 2009. 2. Smith-Bindman R, Miglioretti DL, Johnson E, Lee C, Feigelson HS, Flynn M, et al. Use of diagnostic imaging studies and associated radiation exposure for patients enrolled in large integrated health care systems, 1996-2010. Jama. 2012;307(22):2400-9. 3. Heilmaier C, Zuber N, Bruijins B, Weishaupt D. Does real-time monitoring of patient dose with dose management software increase CT technologists’ radiation awareness? AJR Am J Roentgenol. 2016...