Rasu B. K. Shrestha MD, MBA, Moderator: Advisory Board, General Electric Company Medical Advisory Board, Nuance Communications, Inc Editorial Medical Advisory Board, Anderson Publishing, Ltd Advisory Board, KLAS Enterprises LLC Advisory Board, Peer60

1) Number of CT scans is increasing annually. 2) Wider adoption/ availability of CT scanners. 3) Indications for CT use are increasing (without possible consideration for risks). 4) Rapid increase in number of protocols: Varying equipment leading to protocol variance. A thorough outline of patient-centric approach to dose optimization will be covered, as well as data mining dose data for improved quality, safety and outcomes.

The acceptance of the risks associated with radiation is conditional on the benefits to be gained from the use of radiation. The risks must be restricted and protected against by the application of radiation safety standards. A significant part of the challenge of patient dose management in CT arises from the fact that over-exposure in CT is frequently not detected. In contrast to film based radiography where overexposure results in a dark image, increasing dose in CT and in other digital imaging techniques results in images with: (1) less noise (improved visual appearance) and (2) fewer streak artifacts, (3) although not necessarily with greater diagnostic information. Image quality in CT often exceeds the clinical requirements for diagnosis. It is critical to have a thorough understanding of the basics of radiation dose in CT before we explore the multiple issues around opportunities to reduce these dose parameters. Furthermore, it is also critical to comprehend the role of newer technologies, innovations and developments that are rapidly taking place to address radiation dose reduction in CT - both on the vendor as well as on the private and academic communities. A through and comprehensive understanding of the quality and patient safety issues around this is also critical to making sound decisions around imaging on multiple levels. Different organs have different sensitivities to radiation. Tissue Weighted Factor, WT takes into account the risk to the person exposed to radiation that is not uniform over the entire body. As an example, if 1 mSv is received only by the lungs, this results in an effective dose to that person of 0.12 mSv. This means that 1 mSv received by the lungs poses approximately the same risk as 0.12 mSv to the entire body. Fundamentals such as these will be presented in easily digestible chunks in the refresher course. Also covered will be Protocol Optimization, Scanner Interfacing, Data Connectivity & Interoperability. 

Shrestha, R, Current and Next Generation Health IT Tools to Enable Radiation Exposure Reduction - A Practical Guide.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/13010670.html