How a dose monitoring platform facilitates an iterative and multidisciplinary approach to image quality and dose optimisation

Congress:

EuroSafe Imaging 2018

Poster Number:

ESI-0072

Type:

EuroSafe Imaging

Keywords:

Radiation physics, Action 2 - Clinical diagnostic reference levels (DRLs), Action 6 - Clinical audit tool for imaging, Action 1 - Guidelines, implementation policies, and Clinical Decision Support (ESR iGuide), Action 3 - Optimisation, diagnostic reference levels, image quality, Action 2 - Clinical audit, Action 1 - Clinical decision support, clinical imaging guidelines, CT, Radiation safety, Quality assurance

Authors:

C. Aberle, M. Benz, J. Grothues, R. Menz, G. Stadelmann, T. Heye

DOI:

10.1594/esi2018/ESI-0072

DOI-Link:

https://dx.doi.org/10.1594/esi2018/ESI-0072

Fig. 1: Dose modulation curves showing different behavior of dose adjustment based on...

Fig. 2: Image quality improvement between phase 2 and 3 demonstrating the intended...

Fig. 3: Radiation dose changes between phase 2 and 3 stratified by lower versus higher...

Fig. 4: Behavior of the dose modulation curve depending on the cross-sectional diameter...

Background/introduction

Dose monitoring and dose optimization in a setting with multiple CT scanners in a university hospital environment can be complex and challenging. Various inputs, preferences and needs arising from different disciplines including CT radiological technologists, physicists, radiologists but also clinicians and surgeons have to be considered in order to find a balance between dose optimization and clinically acceptable image quality. Ideally, this should be a continuous process with a distinct workflow and with multidisciplinary participation. A dose monitoring platform can accompany this process with its...

Description of activity and work performed

The local CT dose monitoring and optimization team is comprised of CT radiological technologists, radiologists and physicists. Since September 2013 radiation dose monitoring has been performed using a dedicated monitoring and analysis platform (Radimetrics, Bayer HealthCare). Phase 1: Initial CT abdomen protocol dose settings with a CTDIvol of 10.5 mGy were based on a systematic investigation including phantom lesion detection rate and quantitative iodine measurements for dual energy applications and achieved similar radiation dose, quantitative and qualitative image quality compared to a single energy protocol...

Conclusion and recommendations

An iterative and timely approach to optimizing radiation dose is supported by: Frequent meetings of a multidisciplinary team to bring all necessary information and expertise to the table in order to make dose adjustment decisions A dose monitoring platform allowing for real time monitoring and instant analysis of radiation dose development within an institution. Employment of all measures available and repetitive adjustment to tailor the radiation dose to the intended outcome in image quality. A systematic documentation of CT protocol dose adjustments is necessary in...

Personal/organisational information

Department of Radiology, University Hospital Basel Petersgraben 4 4031 Basel Switzerland

References

[1] Schindera et al, Abdominal Imaging (2017) 42:2562–2570: Systematic radiation dose optimization of abdominal dual-energy CT on a second-generation dual-source CT scanner: assessment of the accuracy of iodine uptake measurement and image quality in an in vitro and in vivo investigations. [2] Annals of the ICRP vol. 46 (2017): ICRP Publication 135, Diagnostic Reference Levels in Medical Imaging. [3] BAG Merkblatt R-06-06 (2010): Diagnostische Referenzwerte in der Computertomographie. [4] R. Treier, A. Aroua, F.R. Verdun, E. Samara, A. Stuessi and Ph.R. Trueb, Radiation Protection Dosimetry...