During the panel discussion at RSNA, the four panel members who are part of the Siemens Radiation Reduction Alliance — Marilyn Siegel, MD, Willi Kalender, PhD, Cynthia McCollough, PhD, and Dushyant Sahani, MD — spoke on three key topics related to dose reduction in CT radiation:
Standardized reference levels
One initiative being pursued by a number of groups is the establishment of radiation dose reference levels. SIERRA, for example, is working toward establishing referential diagnosis reference levels for 10 of the most common CT exams. These standardized reference levels would allow healthcare facilities to benchmark their internal dose radiation practices against these references, thereby allowing providers to monitor and track any outliers and identify what practices are causing CT radiation doses to fall outside of these standardized reference points.
However, experts also conclude that such reference levels should not be translated into any legislative action or lead to any penalizing policies. Depending on very specific parameters — height, weight and age, for example — CT radiation doses should adapt to each individual patient’s needs. Standardized reference levels should simply be used as a tool to measure and improve providers’ practice of varying radiation doses.
Negative coverage of CT radiation
Panel members also spoke about concerns shared by healthcare providers about the negative media coverage on CT radiation. While the media has been covering the negative side effects of CT radiation and the dangers of utilizing high doses, and the panel members all agree that no amount of radiation is absolutely safe; high doses of radiation does not necessarily equate to high risk. There should be a shift in focus away from the negative aspects of CT radiation to the positive benefits to patients.
Panel members add that healthcare providers should not let the increased focus and scrutiny over CT radiation impede what they believe to be sound medical practice. CT dose, they say, should not be reduced just because they are in danger of becoming an “outlier” compared to standard reference levels. If a CT image is taken with too low a dose (a larger patient might need a higher dose), it cannot be used for diagnosis purposes and the CT would need to be performed again, exposing the patient to additional radiation.
Engage your organization’s radiology department
Healthcare providers should empower their respective radiology departments with continuing education and management. Radiologists, physicians and technicians/technologists should work diligently to ensure dose errors and overexposures happen minimally, if at all. This also means working cooperatively to create evidence-based protocols, working with manufacturers and using manufacturer guidelines for each CT scanner.
Empowering radiologists with the proper knowledge, education and training on proper radiation doses allows the providers to relay that same knowledge and confidence to patients. Panel members say patient confidence will only increase if providers are able to clearly explain when it is appropriate to use CT and what dose ranges are safe and appropriate for patients based on their unique body types.
