Consulting with over 26 radiology leaders worldwide, a group of researchers has compiled a list of seven strategies for optimizing CT dose and ensuring safe exposure to radiation during scans.

The authors spoke to radiologists, medical physicists, CT technologists and operational managers from healthcare systems in the U.S., Europe and Japan to compose their framework, and see it as a foundation for CT dose optimization. The feedback they received from these leaders was based on practices already being successfully utilized, reported Health Imaging.

Feedback included:

• Engaging radiologists and technologists – Make discussing issues and proposing changes with a designated radiologist and CT technologist (typically the lead tech) a priority, and communicate changes to those working alongside them, according to 81% of participants


• Creating a CT dose committee – Establish a structured, diverse and inclusive group to implement changes, set goals, develop protocols and manage reviews, said 73%


• Manage organizational changes – Establish clear communication and keep everyone involved in talks. Educate staff, said 65%


• Leadership and support – Provide resources and “man-hours” for completing necessary work. Aim for more than a “lukewarm leadership buy-in” to keep staff engaged and motivated


• Monitoring and benchmarking – Use dose information to make changes and set benchmarks. This can help show where one’s focus should be for creating and adjusting protocols.


• Modifying CT protocols – “Harmonize” protocols to limit variation and avoid confusion. Several participants agreed that their protocols were locked until everyone agreed to modify them.


• Equipment and work rule changes – Invest in newer technology to optimize CT doses. While expensive, it is considered a worthwhile investment, according to the authors. Participants also listed work rules pertaining to developing department procedures and protocols that can be communicated through manuals.

“Advances in medical imaging with CT have led to widespread availability and use of CT imaging to improve healthcare,” corresponding author Robin R. Whitebird, Ph.D., with the University of St. Thomas, Morrison Family College of Health and co-authors explained. “Although there is agreement that imaging doses should be as low as reasonably achievable, widespread variation remains in clinical practice across facilities for similar procedures.”

The list was published in the Journal of the American College of Radiology.