Reducing Variability of Radiation Dose in CT: The New Frontier in Patient Safety.

Abstract

Although reducing radiation dose in CT examinations is an important goal, also important in the management of radiation dose is ensuring consistency of dose administered for a given type of examination. We have implemented an approach to reducing variance in CT radiation dose by standardizing protocols and implementing software that decreases variance. A multifaceted approach to reducing variance in CT radiation dose was utilized: (1) establishment of the Radiation Dose Optimization Committee, (2) standardization of protocols, and (3) implementation of scanner software. Two periods of data were collected: pre-intervention (January 1, 2013, to July 31, 2014) and postintervention (January 1, 2016, to December 31, 2016). The period from August 1, 2014, to December 31, 2015, represented the time the major interventions were performed. The average radiation dose for all CT exams performed during the pre-intervention period (n = 39,314) was 22.3 CTDIvol with an SD of 17.0. The average radiation dose for all CT exams performed during the postintervention period (n = 49,863) was 13.6 CTDIvol with an SD of 9.01. The postintervention variance was significantly decreased (P < .0001). A significant decrease in the variability of our network CT radiation dose was achieved as a result of a combination of standardizing protocols across the network and implementation of advanced software that effectively managed radiation dose, all overseen by the Radiation Dose Optimization Committee.