Comparison of General Chest CT examinations performed across 27 departments in nine countries and with 14 different CT models from three vendors

Congress:

EuroSafe Imaging 2017

Poster Number:

ESI-0005

Type:

EuroSafe Imaging

Keywords:

Diagnostic procedure, CT, Lung, Action 2 - Clinical diagnostic reference levels (DRLs), Action 3 - Optimisation, diagnostic reference levels, image quality, Dosimetric comparison

Authors:

K. Katsari, L. Oktabcova, A. Papachristodoulou, S. Puggina, G. Volford, A. Kaczor, V. Herédia, A. Cojocaru, X. Boulanger, R. Gökcan, B. Cavli, R. Illing

DOI:

10.1594/esi2017/ESI-0005

DOI-Link:

https://dx.doi.org/10.1594/esi2017/ESI-0005

Fig. 1: JSO dashboard

Fig. 2: Root - cause analysis of 5% justified high dose level alerts

Fig. 3: CTDIvol per country

Fig. 4: DLP per country

Background/Introduction

Technological developments in Computed Tomography (CT) in the last two decades have resulted in a continuing increase of the number of examinations performed. The contribution to the annual cumulative effective dose by CT examinations has also increased substantially, raising concerns about the associated ionizing radiation risk[1]. International Basic Safety Standards for Protection against Ionizing Radiation require that a radiologic examination be performed only in the case of a justifiable clinical indication and, in that case, that the patient’s radiation exposure be limited to the amount...

Description of activity and work performed

Data was collected from 27 departments in nine countries for 3,183 patients that underwent Chest CT as a first examination on 14 different CT models from three vendors between February and March 2016. The reference standard Chest CT protocol was defined with a maximum of two irradiations, one pre and one post contrast. Departments with protocols of less than 20 examinations were excluded from the study. Non-diagnostic series and test examinations were excluded from the data analysis. An analytics tool (DoseWatch, GEHC, Mil., USA), a...

Conclusion and Recommendations

94% of examinations were performed with a total number of irradiations complying with the standard and 94% did not receive high dose level alerts (Image 1). From the 5% of justified high dose level alerts, 50% was attributed to patients being overweight with BMI from 25 and above (Image 2). Median CTDIvol ranged from 2.18mGy to 11.79mGy (Image 3) and median DLP ranged from 77.50 mGy.cm to 467.20 mGy.cm (Image 4). 52% of the protocols used were within the DRL (Image 1). The analysis of...

Personal/Organisational information

Katia Katsari, medical physicist, Affidea HQ, Netherlands/Hungary Lubica Oktabcova MD, radiologist, Affidea Prague, Czech Athanasia Papachristodoulou MD, radiologist, Affidea Thessaloniki, Greece Stefano Puggina MD, radiologist, Affidea Monselice, Italy Gabor Volford MD, radiologist, Affidea Péterfy Hospital and Trauma Center Budapest, Hungary Artur Kaczor MD, radiologist, Affidea Kielce, Poland Vasco A. G. Heredia MD, radiologist, Affidea Evora, Portugal Adriana Cojocaru MD, radiologist, Affidea Bucharest, Romania Xavier Boulager MD, radiologist, Affidea Fribourg, Switzerland Recai Gokcan MD, radiologist, Affidea Istanbul, Turkey Baris Cavli, radiographer, Affidea Istanbul, Turkey Rowland Illing...

References

1. David J. Brenner, Ph.D, D.Sc., and Eric J. Hall, D. Phil., D.Sc.: Computed Tomography – An Increasing Source of Radiation Exposure; The New England Journal of Medicine 2007;357:2277-84. 2. Official Journal of the European Union, COUNCIL DIRECTIVE 2013/59/EURATOM of 5 December 2013, page L 13/2, point (12). 3. Justin E. Costello, Nathan D. Cecava, Jonathan E. Tucker, Jennifer L. Bau. CT Radiation Dose: Current Controversies and Dose Reduction Strategies. American Journal of Radiology 201, December 2013; pg.1283-1290. 4. John R. Mayo, MD, John Aldrich,...