Keywords:
Oncology, Radioprotection / Radiation dose, CT, Diagnostic procedure, Radiation safety, Dosimetric comparison
Authors:
P. De Marco, D. Origgi, C. Rampinelli, V. Giannetta, L. Borrelli, M. Bellomi; Milan/IT
DOI:
10.26044/ecr2019/C-2945
Conclusion
In this study we showed a possible framework to optimize chest-abdomen-pelvis examination for oncological patients.
A BMI-based table was suggested to choose a proper protocol according to patient body size.
Results of the first period were not promising,
since more than 50% of all patients and more than 60% of patients with BMI lower than 26,
were not scanned with the optimized protocol.
Written reminder and continuous monitoring allowed use to reduce the percentage of non-optimized examinations to 28% and 35% respectively.
Differences in image quality,
even when statistically significant,
were small,
and all images were evaluated as diagnostic.
Thus,
it is possible to achieve dose reduction of 40% or more when small patients are scanned with proper protocols and this is of primary importance for oncological institutions,
since long survival patients are subjected to multiple examinations during the course of their disease.
In addition,
with this study we showed the importance of dose tracking software like Radimetrics as useful tools for collecting and handling large amount of data,
as first step for optimization.
In conclusion,
this study showed a simple and effective way to optimize protocols according to BMI.
However,
continuous monitoring and a comprehensive approach involving medical physicists,
radiologists and radiographers are mandatory to further reduce the percentage of non-optimized examination.