Purpose or learning objective
To establish Diagnostic Reference Levels for Common CT Procedures in an orthopaedic clinical setting.To establish Diagnostic Reference Levels for two CT Musculoskeletal Interventional Procedures.To aid optimisation of CT Procedures in a dedicated orthopaedic clinical setting.
Methods or background
In October 2021, the National Orthopaedic Hospital Cappagh, Dublin, Ireland installed their first CT scanner (Siemens Definition Edge). To date over 4000 patients have been scanned on this scanner which is the only CT scanner in the country which is dedicated for orthopaedic imaging. Medical Exposure to ionising radiation is one of the largest contributors to artificial ionising radiation exposure to the Irish population (10.4%). CT accounsts for 62% of the radiation dose from all medical exposure in Ireland but only 11 % of the...
Results or findings
The workload in the CT scanner was reviewed and it was decided to select a mixture of CT guided interventional procedures and commonly requested anataomy for inclusion in the study. Cervical Facet Joint and Lumbar Spine Joint Injections are commonly carried out on the CT scanner by a number of different radiologists. Radiologists usually remain outside of the scan room during these procedures in order to keep their radiation exposure to a minimun. Four body parts commonly scanned were choosen for inclusion in the study:...
Conclusion
Education and training of CT radiographers is key in the optimisation process. During the onsite training in the NOHC CT department, radiographers are taught the importance of minimising the scan area to required anatomical regions only and to avoid unnecessary repeat scanning. Each patient request is carefully reviewed before scanning commences to ensure the correct protocols and scan areas are selected. Technology provided by the scanner such as CARE Dose4D and CARE kV are rountinuely used to achieve significant dose reducations based on the individual...
References
11Reference 1: EPA HIQA Ionising Radiation Dose ReportReference 2: HIQA Guidance on the Establishment, Use and Review of Diagnostic Reference Levels for medical exposure to ionising radiationReference 3: Patient doses in CT Examinations in SwitzerlandReference 4: Siemens Healthineers CARE RightReference 5: Siemens Healthineers iMAR
Personal information and conflict of interest
M. Smyth:
Nothing to disclose
B. Byrne:
Nothing to disclose
L. Gavagan:
Nothing to disclose
S. Eustace:
Nothing to disclose
