Yasir Andrabi MD, MPH, Presenter: Nothing to Disclose

Jorge Mario Fuentes MD, Abstract Co-Author: Nothing to Disclose

Mukta Dilipkumar Agrawal MBBS, MD, Abstract Co-Author: Nothing to Disclose

Manuel Patino MD, Abstract Co-Author: Nothing to Disclose

Dushyant V. Sahani MD, Abstract Co-Author: Research Grant, General Electric Company

To evaluate the effectiveness of an automated dose monitoring (ADM) in assuring success to adhere with dose optimization protocols using kidney stone CT exams (KSCT) as a model.

In this IRB approved study, all Kidney stone exams performed between January 2013-January 2014 on 17 of 21 scanners (GE=12, Philips=2 and Siemens=3) were retrieved using an ADM software (eXposure TM, Bayer). Out of total 136,254 exams, 1935 exams (M:F=1031:904, Age=56.7 Years, BW=81 Kgs) were performed for kidney stone indications. Mean radiation doses (SSDE, DLP) were tracked for different scanners, vendors, reconstruction techniques, technicians, time of scan and radiation dose outliers (>2 SD above mean) were identified using a box plot. Doses were comapred with DIR National averages.

Mean Radiation doses (SSDE=9.8±3.9 mGy, DLP=420.1 ±240mGy-cm) were 38% lower than national averages (DIR feedback report 2013). In 75 patients DLP greater than 2SD (> 900mGy-cm) was noted, of these 70 patients had excessive body weight (mean=112.4 Kgs). In 3 patients higher doses were due to increase in scan area while in 2 patients, incorrect protocols was applied. The exam protocols were reviewed with 3 technicians involved in these 5 exams and proper education was provided. The time of scan acquisition i.e. 8 AM to 6 PM or after 6 PM had no impact on radiation dose outliers. 

ADM software enabled us to identify 5 patients who received radiation doses higher than expected due to protocol violations, necessitating need for continuous dose tracking and continued education and training of technologists and radiologists.

Close monitoring of radiation doses is essential to adhere to ALARA principle and improve patient care. ADM software is effective way of tracking dose outliers and any protocol deviations and paves path for quality assurance in CT and provides opportunity for education and continuous protocol optimizations.

Andrabi, Y, Fuentes, J, Agrawal, M, Patino, M, Sahani, D, Using Software based Solution for Quality Assurance in a Sub Specialized, Multivendor CT Practice.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14019446.html