Establishing Tomography Dose Monitoring: a Tool to Improve Educational Strategies for Radiological Protection and Patient Safety in a Private Hospital in Brazil

Congress:

EuroSafe 2022

Poster Number:

ESI-14553

Type:

EuroSafe Imaging

Keywords:

Radioprotection / Radiation dose, CT, Education, Education and training

Authors:

M. Bernardo, F. Morgado, A. A. Moscatelli, M. C. Cuter Rodel, L. M. Bellegard, R. G. Henschel, B. G. Valese, D. M. Sales, P. R. P. COSTA

DOI:

DOI-Link:

https://dx.doi.org/

Purpose or learning objective

To apply continuous dose monitoring software in Tomography as a tool to educate radiologic professionals and improve radiological protection and patient safety in a Private Hospital in Brazil.

Methods or background

Background The increase in radiological exams caused concern to the academic and scientific community [1-4]. Cumulative effective dose from recurrent CT examinations is being studied [5]. CT exams contributes to more than 50% of the radiation dose in diagnostic exams [1], and variations in scan protocols and radiation doses is reported, demonstrating the importance of dose monitoring as tool to improve dose optimization and radiation protection for patients [6]. The dose report records automatically demonstrate the CTDIvoland DLP values; and it may also relate the...

Results or findings

A total of 1621 CT exams were analyzed. The median value for CTDIvol (in mGy) and DLP (in mGy.cm) for CT modalities evaluated sample for non-contrast Head (cranial) CT: 0-2 y old (N=54; DLP [532mGy.cm]); 3-6 y old (N=39; DLP [588mGy.cm]) ; 7-10 y old (N=27), DLP [532mGy.cm]); 11-14 y old (N=43); DLP [588mGy.cm]); 15-18 y old (N=42;DLP [581mGy.cm]); adult (N=1416; DLP [581mGy.cm]). The main challenges for the implementation of dose monitoring are: radiologists are not used to dealing with exam dose reference levels; the...

Conclusion

Monitoring CT data was a tool to alert optimization. Education to radiological staff, especially to pediatric exams, must be permanent. Data collection and audit can be a good instrument to improve skills and patient radiological protection/safety. Engagement of the manager and supervisor radiologist is primarily important to change culture.

References

[1] World Health Organization. Coimbra Health School. “Communicating risks in paediatric imaging: information to support health care discussions about bene t and risk” [Internet]. 2016 [access on 18 dec. 2021]. Available from: https://apps.who.int/iris/bitstream/handle/10665/205033/9789898252463- por.pdf;jsessionid=6C363A111A00269EC0FD9C468209C79F?sequence=8. [2] International Atomic Energy Agency. Bonn Call for Action.[access in 4 jan. 2022]. Available from: https://www.iaea.org/resources/rpop/resources/bonn-call-for-action-platform [3] NCRP. Ionizing Radiation Exposure of the Population of the United States. NCRP Report 160; 2009. National Council on Radiation Protection and Measurements, Bethesda, MD. [4] Brenner DJ, Hall EJ. Computed tomography-an increasing source of...

Personal information and conflict of interest

M. O. B. Bernardo: Nothing to disclose F. Morgado: Nothing to disclose A. A. Moscatelli: Nothing to disclose M. C. Cuter Rodel: Nothing to disclose L. M. Bellegard: Nothing to disclose R. G. Henschel: Nothing to disclose B. G. Valese: Nothing to disclose D. M. Sales: Nothing to disclose P. R. P. COSTA: Nothing to disclose

Fig 1: Facility and DIR ACR median value for CTDI vol to Paediatric Brain CT exams in...

Fig 2: Number of Brain CT for each Paediatric Age Group Analyzed from Jan/Jun 2020

Fig 3: Facility 25th, Median and 75th DLP per Scan value (in mGy.cm) for Paediatric...

Fig 4: Facility median DLP per Scan (in mGy.cm) for Adult Brain CT compared to DIR ACR...

Fig 5: Example of Facility’s Performance on the six High Volume ACR Dose Index...