EuroSafeImaging in an academic centre in Canada: Clinical implementation of a CT image quality feedback tool

Congress:

EuroSafe Imaging 2019

Poster Number:

ESI-0064

Type:

EuroSafe Imaging

Keywords:

Action 2 - Clinical diagnostic reference levels (DRLs), Action 6 - Clinical audit tool for imaging, Action 13 - Stakeholder engagement and collaboration, Radioprotection / Radiation dose, CT, Radiation safety, Education and training, Quality assurance

Authors:

P. Rogalla, T. D. Do, H. U. Kauczor, C. Farrell, C. Burton, W. Stiller

DOI:

10.26044/esi2019/ESI-0064

DOI-Link:

https://dx.doi.org/10.26044/esi2019/ESI-0064

Fig. 1: CT Dose Management Framework.

Fig. 2: Technology and Tools used during the planing phase.

Fig. 3: CT image quality feedback tool. The accession number can be copied from the...

Fig. 4: Clinical examples for feedback provided by different radiologists within one...

Background/introduction

Radiation dose protection has become an essential pillar in Medical Imaging worldwide [1-3]. With CT being a significant contributor to radiation dose in patients, the Joint Department of Medical Imaging in Toronto (JDMI), Canada, has taken a comprehensive approach as the first Medical Imaging Department in Canada, in order to harmonize CT imaging protocols, track radiation doses and most importantly, develop a feedback tool for radiologist on image quality and related radiation dose concerns. In today’s Canadian healthcare landscape, there are no formal guidelines for...

Description of activity and work performed

An iterative four phase protocol change management approach was used for the CT dose committee to achieve the goals - identify, plan, execute and monitor (Figure 1,2). In the identification phase, a CT dose tracker tool (Radimetrics, Bayer) was leveraged to identify the most frequently used protocols, mapped out by scanner and location, and to detect of opportunities for dose reduction. With an array of various dose metrics, the dose length product (DLP) was selected as the best metric to track dosage for this committee...

Conclusion and recommendations

The CT dose committee has made a positive impact by achieving a dose reduction ranging between 13% and 37% (p<0.001) for high volume protocols over 15,183 cases assessed. Also, protocol parameters were successfully harmonized across all five hospital sites. The development and implementation of a CT image quality feedback tool provided essential and integral support for the CT dose committee as it allowed for “closing the loop” in an efficient and effective way, while at the same time, providing trackable data and the framework for...

Personal/organisational information

JDMI operates 17 CT scanners in 5 hospitals (Canon, Siemens) and generates approx. 140,000 CT studies annually. JDMI radiologists are sub-specialized in 7 Divisions: Abdomen, Cardiothoracic, Vascular-Interventional, Nuclear and Molecular, Breast, Musculoskeletal Imaging, and Neuroradiology. Patrik Rogalla (lead author) founded the CT dose committee and signs responsible for the design and content of the CT image quality feedback tool. As the Director of CT imaging at JDMI, he is the physician lead for the CT dose committee and reviews all critical feedback provided through the...

References

1. Stiller W. Basics of iterative reconstruction methods in computed tomography: A vendor-independent overview. Eur J Radiol. 2018 Dec;109:147-154. doi: 10.1016/j.ejrad.2018.10.025. Epub 2018 Oct 26 2. Yabuuchi H, Kamitani T, Sagiyama K, Yamasaki Y, Matsuura Y, Hino T, Tsutsui S, Kondo M, Shirasaka T, Honda H. Clinical application of radiation dose reduction for head and neck CT. Eur J Radiol. 2018 Oct;107:209-215. doi: 10.1016/j.ejrad.2018.08.021. Epub 2018 Aug 24 3. Zinsser D, Marcus R, Othman AE, Bamberg F, Nikolaou K, Flohr T, Notohamiprodjo M. Dose Reduction...