Referral guidelines for diagnostic radiology are available in Belgium. Their main goal is to inform referring physicians on the optimal use of different imaging modalities and their associated radiation dose. The guidelines are composed by the Belgian Society of Radiology (BSR), and are available to the public on the website of the federal authorities1. While the list of referral guidelines is primarily intended to be used by referring physicians, our work focused on streamlining our internal radiology workflow using these guidelines. Despite the availability of...

A list of clinical indications for lumbar spine conventional radiology (CR) was taken from national referral guidelines1. To this list we added clinical indications which occasionally occur in our practice, but are not necessarily correct. This list was reviewed by four senior radiologists to confirm relevance, and to establish which specific radiographs need to be acquired (Figure 1). Additionally, specific practical guidelines regarding centering, inclination and fluoroscopy use, were composed for radiographers (Figure 2). Both Figures were printed out and presented at the console. Data...

Median fluoroscopy time decreased significantly from 20 to 6 seconds (p<0,001) and 12 to 8,5 seconds (p=0,010) in CR1 and CR2 respectively (Figure 3). However, the DAP decreased only in CR1, from 4025 mGy.cm² to 3046 mGy.cm² (p=0,047). In CR2, the DAP remained approximately stable, from 3916 mGy.cm² to 3828 mGy.cm² (p=0,630) (Figure 4). The use of referral guidelines has the potential to optimize clinical performance, and to reduce radiation dose. More specifically, we reduced DAP by 24,3% and fluoroscopy time by 70%. However, we...

Timo De Bondt, MSc, PhD Medical Physics consultant [email protected] Jonathan Van Baekel Radiographer [email protected]

1. Refferal guidelines in Belgium