Reducing Radiation Dose in CT Abdomen and Pelvis Studies PDF
Preview Reducing Radiation Dose in CT Abdomen and Pelvis Studies
Reducing Radiation Dose in Abdominal CT Studies: ACR Dose Index Registry Data as an Imppetus for QQualityy Impprovement Mark P. Supanich, Ph.D.1 Nicholas Bevins, Ph.D.2 DDaanniieell MMyyeerrss, MMDD22 1Rush University Medical Center - Chicago, IL 2Henry Ford Health System- Detroit, MI Contact: [email protected] Disclosures • Nothing to disclose Background • The Radiology division of the Henry Ford Medical covers imaging for 3 hospitals and a number of outpatient centers • CT scanners include systems from 3 major vendors (n=13) • Only data from scanners with the ability to reconstruct 64 slices were included in this study ▫ Vendor 1, n=1 ▫ Vendor 2, n=2 ▫ Vendor 3, n=5 • No scanners empployyed iterative reconstruction Motivation • Continuous quality improvement is a priority in the Radiologgyy deppartment • Matching radiation dose and image quality for the same pprotocol across all scanners was identified as a goal by the radiologists and medical pphyysicists Tools Used • eXposureTM software from Bayer Healthcare used to collect dose and protocol information • IInsttiittuttiionall parttiiciipattiion iin AAmeriican CCollllege off Radiology (ACR) CT Dose Index Registry (DIR) ▫ SSeemmii-aannnnuuaall rreeppoorrttss ooff iinnssttiittuuttiioonnaall ddoossee mmeettrriiccss broken down by orderable ▫ Summary of dose metrics from 300+ participating institutions included Collection of Baseline Data • Institutional dose metrics and scan information collected by eXposureTM from 7/2011 through present including ▫ CTDI vol ▫ SSDE ▫ Master Scan Protocol • Participation in DIR from 1/2012 through present • Protocols on scanners from same vendor all equivalent • Image thickness within 0.25 mm on all scanners • CT Abdomen Pelvis ((with or without contrast)) exams analyyzed ▫ Image quality reference parameter on multiphase exams are equal VVeennddoorr 11 BBaasseelliinnee DDaattaa CTDI Values Vendor 1 vol 4400 y c 30 n e 20 u q 10 e rr F 0 0 2 4 6 8 0 2 4 6 8 0 2 4 6 8 0 2 4 6 8 0 2 4 e 1 1 1 1 1 2 2 2 2 2 3 3 3 3 3 4 4 4 r o M CCTTDDII MMeeaann:: 1199.77 mmGGyy Bin voll CTDI Median: 17.3 mGy vol SSDE Mean: 21.7 mGy SSDE Median: 20.44 mGyy N=389 VVeennddoorr 22 BBaasseelliinnee DDaattaa CTDI Values Vendor 2 vol 300 y c n200 e u 100 q ee r 0 F 0 3 6 9 2 5 8 1 4 7 0 3 6 9 2 5 1 1 1 2 2 2 3 3 3 3 4 4 Bin CCTTDDII MMeeaann:: 1166.99 mmGGyy voll CTDI Median: 17.2 mGy vol SSDE Mean: 19.3 mGy SSDE Median: 20.1 mGyy N=2565 VVeennddoorr 33 BBaasseelliinnee DDaattaa CTDI Values Vendor 3 vol 550000 y c 400 n 300 e u 200 q e 100 rr F 0 0 2 4 6 8 0 2 4 6 8 0 2 4 6 8 0 2 4 6 8 0 2 4 e 1 1 1 1 1 2 2 2 2 2 3 3 3 3 3 4 4 4 r o M CCTTDDII MMeeaann:: 1188.99 mmGGyy Bin voll CTDI Median: 19.5 mGy vol SSDE Mean: 21.6 mGy SSDE Median: 21.99 mGyy N=2160 Notes on Histograms • Vendor 2 offered a maximum tube current settingg which was utilized resultingg in a maximum CTDIvol of ~26 mGy for the standard acqquisition • The output of Vendor 3’s systems were tube current limited to outpputs of ~255 mGyy for standard acquisition technique
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