ACR White Paper-Based Comprehensive Dose Reduction Initiative Is Associated With a Reversal of the Upward Trend in Radiation Dose for Chest CT

Udit Rawat, Stuart L. Cohen, Jeffrey M. Levsky, Linda B. Haramati

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: In 2010, the authors' department implemented a comprehensive dose reduction strategy based on the ACR white paper on radiation dose in medicine. The aim of this study was to evaluate the effectiveness of the dose reduction program. Methods: In total, 1,234 adult chest CT scans from 2007 to 2012 were analyzed retrospectively, with institutional review board approval and a waiver of the requirement for informed consent. The primary outcome was effective dose in millisieverts during the three-year periods before (2007-2009) and after (2010-2012) dose reduction implementation. Dose trends were analyzed by fitted linear modeling. The use and effects on total exposure of dose reduction strategies (high pitch, adaptive statistical iterative reconstruction [ASIR], and low tube voltage) were analyzed. Results: The overall mean dose for chest CT was 7.3 ± 5.1 mSv. The mean dose decreased by 30%, from 9.2 mSv (2007-2009) to 6.5 mSv (2010-2012) (P <.001). From 2007 to 2009, the mean dose increased by 1.2 mSv per year (P <.01). From 2010 to 2012, the mean dose decreased by 1.1 mSv per year (P <0.01). High-pitch technique, ASIR, and low tube voltage increased significantly after dose reduction implementation. High pitch and ASIR were significantly associated with a reduced dose, whereas the effect of reduced voltage was not significant. Conclusions: Reductions in radiation exposure from medical imaging rely on ongoing technical developments and consistent, vigilant use of dose reduction strategies. This comprehensive dose reduction strategy significantly reduced radiation exposure from chest CT. Annual increases in radiation dose reversed after the strategy was implemented and continued to decline over the study period.

Original languageEnglish (US)
JournalJournal of the American College of Radiology
DOIs
StateAccepted/In press - 2015

Fingerprint

Thorax
Radiation
Research Ethics Committees
Diagnostic Imaging
Informed Consent
Medicine
Radiation Exposure

Keywords

  • Chest CT
  • Dose reduction
  • Radiation dose

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{f4fdd50d385347c2bba15262a984c6c5,
title = "ACR White Paper-Based Comprehensive Dose Reduction Initiative Is Associated With a Reversal of the Upward Trend in Radiation Dose for Chest CT",
abstract = "Purpose: In 2010, the authors' department implemented a comprehensive dose reduction strategy based on the ACR white paper on radiation dose in medicine. The aim of this study was to evaluate the effectiveness of the dose reduction program. Methods: In total, 1,234 adult chest CT scans from 2007 to 2012 were analyzed retrospectively, with institutional review board approval and a waiver of the requirement for informed consent. The primary outcome was effective dose in millisieverts during the three-year periods before (2007-2009) and after (2010-2012) dose reduction implementation. Dose trends were analyzed by fitted linear modeling. The use and effects on total exposure of dose reduction strategies (high pitch, adaptive statistical iterative reconstruction [ASIR], and low tube voltage) were analyzed. Results: The overall mean dose for chest CT was 7.3 ± 5.1 mSv. The mean dose decreased by 30{\%}, from 9.2 mSv (2007-2009) to 6.5 mSv (2010-2012) (P <.001). From 2007 to 2009, the mean dose increased by 1.2 mSv per year (P <.01). From 2010 to 2012, the mean dose decreased by 1.1 mSv per year (P <0.01). High-pitch technique, ASIR, and low tube voltage increased significantly after dose reduction implementation. High pitch and ASIR were significantly associated with a reduced dose, whereas the effect of reduced voltage was not significant. Conclusions: Reductions in radiation exposure from medical imaging rely on ongoing technical developments and consistent, vigilant use of dose reduction strategies. This comprehensive dose reduction strategy significantly reduced radiation exposure from chest CT. Annual increases in radiation dose reversed after the strategy was implemented and continued to decline over the study period.",
keywords = "Chest CT, Dose reduction, Radiation dose",
author = "Udit Rawat and Cohen, {Stuart L.} and Levsky, {Jeffrey M.} and Haramati, {Linda B.}",
year = "2015",
doi = "10.1016/j.jacr.2015.07.022",
language = "English (US)",
journal = "Journal of the American College of Radiology",
issn = "1558-349X",
publisher = "Elsevier BV",

}

TY - JOUR

T1 - ACR White Paper-Based Comprehensive Dose Reduction Initiative Is Associated With a Reversal of the Upward Trend in Radiation Dose for Chest CT

AU - Rawat, Udit

AU - Cohen, Stuart L.

AU - Levsky, Jeffrey M.

AU - Haramati, Linda B.

PY - 2015

Y1 - 2015

N2 - Purpose: In 2010, the authors' department implemented a comprehensive dose reduction strategy based on the ACR white paper on radiation dose in medicine. The aim of this study was to evaluate the effectiveness of the dose reduction program. Methods: In total, 1,234 adult chest CT scans from 2007 to 2012 were analyzed retrospectively, with institutional review board approval and a waiver of the requirement for informed consent. The primary outcome was effective dose in millisieverts during the three-year periods before (2007-2009) and after (2010-2012) dose reduction implementation. Dose trends were analyzed by fitted linear modeling. The use and effects on total exposure of dose reduction strategies (high pitch, adaptive statistical iterative reconstruction [ASIR], and low tube voltage) were analyzed. Results: The overall mean dose for chest CT was 7.3 ± 5.1 mSv. The mean dose decreased by 30%, from 9.2 mSv (2007-2009) to 6.5 mSv (2010-2012) (P <.001). From 2007 to 2009, the mean dose increased by 1.2 mSv per year (P <.01). From 2010 to 2012, the mean dose decreased by 1.1 mSv per year (P <0.01). High-pitch technique, ASIR, and low tube voltage increased significantly after dose reduction implementation. High pitch and ASIR were significantly associated with a reduced dose, whereas the effect of reduced voltage was not significant. Conclusions: Reductions in radiation exposure from medical imaging rely on ongoing technical developments and consistent, vigilant use of dose reduction strategies. This comprehensive dose reduction strategy significantly reduced radiation exposure from chest CT. Annual increases in radiation dose reversed after the strategy was implemented and continued to decline over the study period.

AB - Purpose: In 2010, the authors' department implemented a comprehensive dose reduction strategy based on the ACR white paper on radiation dose in medicine. The aim of this study was to evaluate the effectiveness of the dose reduction program. Methods: In total, 1,234 adult chest CT scans from 2007 to 2012 were analyzed retrospectively, with institutional review board approval and a waiver of the requirement for informed consent. The primary outcome was effective dose in millisieverts during the three-year periods before (2007-2009) and after (2010-2012) dose reduction implementation. Dose trends were analyzed by fitted linear modeling. The use and effects on total exposure of dose reduction strategies (high pitch, adaptive statistical iterative reconstruction [ASIR], and low tube voltage) were analyzed. Results: The overall mean dose for chest CT was 7.3 ± 5.1 mSv. The mean dose decreased by 30%, from 9.2 mSv (2007-2009) to 6.5 mSv (2010-2012) (P <.001). From 2007 to 2009, the mean dose increased by 1.2 mSv per year (P <.01). From 2010 to 2012, the mean dose decreased by 1.1 mSv per year (P <0.01). High-pitch technique, ASIR, and low tube voltage increased significantly after dose reduction implementation. High pitch and ASIR were significantly associated with a reduced dose, whereas the effect of reduced voltage was not significant. Conclusions: Reductions in radiation exposure from medical imaging rely on ongoing technical developments and consistent, vigilant use of dose reduction strategies. This comprehensive dose reduction strategy significantly reduced radiation exposure from chest CT. Annual increases in radiation dose reversed after the strategy was implemented and continued to decline over the study period.

KW - Chest CT

KW - Dose reduction

KW - Radiation dose

UR - http://www.scopus.com/inward/record.url?scp=84951304673&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84951304673&partnerID=8YFLogxK

U2 - 10.1016/j.jacr.2015.07.022

DO - 10.1016/j.jacr.2015.07.022

M3 - Article

C2 - 26482816

AN - SCOPUS:84951304673

JO - Journal of the American College of Radiology

JF - Journal of the American College of Radiology

SN - 1558-349X

ER -