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Acr And Radiation Dose Issues

  • What can you do in your practice today
    -Tube current selection is now controlled by automatic tube current modulation systems that automatically adjust tube output to a desired operator selected image noise level. This alone can reduce dose by up to 77%
    -Tube voltage selection can substantially decrease dose when going from 140 to 120, or from 120 to 100 mAs (4th power). You may need to increase mAs to maintain quality in these cases. Lower tube voltage will often lower the volume of contrast needed especially in CTA studies
  • The ACR recommendations addressed all parties
    - Referring physician- educate about radiation exposure
    - Radiologists- increase resident training in regards to dose, develop radiation dose modules as part of MOC, make CT protocols more available, encourge group to develop safety teams
    - Technologists- increased in service training, require each site have at least 1 tech with advanced registry in CT
    - Patients- work with patient advocacy groups to provide the facts
    - Medical physicists- more training of non-radiologists who use radiation and of retraining radiologists
    - Vendors- work with NEMA to ensure ALARA is followed, develop standardized ways to measure and display dose
    - Regulatory agencies- work closely with FDA and NRC to combine efforts, encourage more regulations on use of radiation but do it uniformly
  • The ACR recommendations addressed all parties
    - Referring physician
    - Radiologists
    - Technologists
    - Patients
    - Medical physicists
    - Vendors
    - Regulatory agencies
  • " In a 2009 paper, Fazel et al showed that myocardial perfusion imaging alone contributed to >22% of the total effective dose from medical imaging studies, while CT of the abdomen, pelvis, and chest accounted for nearly 38%."

    ACR White Paper on Radiation Dose in Medicine: Three Years Later
    Amis Jr ES, Butler PF
    J Am Coll Radiol 2010;7:865-870

  • "Since the publication of the white paper, 30 of the 37 recommendations have been completed or are in progress."

    ACR White Paper on Radiation Dose in Medicine: Three Years Later
    Amis Jr ES, Butler PF
    J Am Coll Radiol 2010;7:865-870

     

  • "The ACR, an advocate for radiation safety since its inception in 1924, convened the ACR Blue Ribbon Panel on Radiation Dose in Medicine in 2006 and issued 37 recommendations for the College to address these issues. This report updates the status of these recommendations."

    ACR White Paper on Radiation Dose in Medicine: Three Years Later
    Amis Jr ES, Butler PF
    J Am Coll Radiol 2010;7:865-870

  • "Although data derived from the atomic bomb survivors in Japan and other events suggest that the expanding use of imaging modalities using ionizing radiation may eventually result in an increased incidence of cancer in the exposed population, this problem can likely be minimized by preventing the inappropriate use of such imaging and by optimizing studies that are performed to obtain the best image quality with the lowest radiation dose."

    American College of Radiology White Paper on radiation Dose in Medicine
    Amis ES et al.
    J Am Coll Radiol 2007;4:272-284
  • "this problem can likely be minimized by preventing the inappropriate use of such imaging and by optimizing studies that are performed to obtain the best image quality with the lowest radiation dose."

    American College of Radiology White Paper on radiation Dose in Medicine
    Amis ES et al.
    J Am Coll Radiol 2007;4:272-284