J. Anthony Seibert PhD, Presenter: Nothing to Disclose

1) Describe the provisions of the California State law on dose reporting for computed tomography (CT) scanners. 2) Demonstrate ways in which the required elements volume Computed Tomography Dose Index (CTDIvol) and Dose Length Product (DLP) can be placed into the radiology report. 3) Discuss discrepancies regarding the relationship between CTDIvol and patient dose, and issues in accumulating dose indices for CT scans in a multi-series exam and for individual exams over time. 4) Report on the status of compliance with the statutes of the law.

Radiation over-exposure for computed tomography (CT) perfusion studies occurring in the 2008-2009 timeframe resulted in California Senate Bill 1237, legislation that was authored by Senator Padilla in response to these incidents. The legislation was signed by the Governor in September 2010. The law contains three parts: (1) Recording CT dose indices for each patient, placing these values in the radiology report, and verifying accuracy of the volume Computed Tomography Dose Index (CTDIvol); (2) Requiring accreditation for all CT scanners performing diagnostic exams that are under the authority of the California Department of Public Health; (3) Reporting of radiation exposures that exceed specified limits to organs, cause unanticipated erythema or hair loss, or inappropriate irradiation to body parts not ordered by a physician. Part 1 of the law commenced on July 1, 2012, and the other two parts are to commence on July 1, 2013. This presentation describes the steps taken to comply specifically with Part 1 of the law. To ensure compliance, an automated extraction and delivery of the CTDIvol and DLP indices to the radiology report were implemented. However, the legislation does not provide guidance on how to: (1) adjust CTDIvol for patient size; (2) deal with CT exams having multiple different series, each with individual dose indices; (3) sum CTDIvol and DLP for the same or different body areas scanned (if appropriate). The consequence is variable reporting at the initial implementation of the law, which requires standardized reporting metrics. Recommendations by the University of California Dose Optimization and Standardization Endeavor (UC DOSE) is discussed in this context, with relevant solutions described and specific examples demonstrated. To conclude, an update from the users perspective of compliance, as well as reporting of the status from the State of California Department of Public Health office is provided.   

Seibert, J, Initial Experience with California Law on Reporting Dose from CT.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/12021243.html