Dialing in on dose

Any list of the top topics in radiology over the last year certainly would have to include CT dose reduction.

This shouldn’t be surprising. The growth of imaging in the last two decades has ignited concerns about rising costs, but right behind the financial considerations is the concern about radiation exposure.

Pediatric CT in particular is a concern as children are more radiosensitive than adults. Recent research has shown substantial increases in the use of CT among children for symptoms such as abdominal pain. This increase in CT use for pediatric patients has pressured providers to ensure they are doing everything they can to reduce dose. Health Imaging examined the challenges radiology practices face in "Pediatric CT: Growing Pains."

There have been plenty of successes on the dose reduction front in recent months. Preliminary results of an ongoing trial published online in the American Journal of Roentgenology (AJR) have shown that model-based iterative reconstruction can cut CT dose more than 70 percent compared with traditional reconstruction methods. Meanwhile, a study in Radiology demonstrated a reduction in CT dose during kidney stone evaluation using adaptive statistical iterative reconstruction.

Another component of dose reduction is managing imaging utilization itself. Research has shown imaging use plateaued after the spike in the early 2000s, and efforts to understand what drives utilization continue. A study in the November issue of AJR, for example, found that physicians who manage emergency department visits ordered CT exams at nearly three times the rate of nonphysicians.

The future of dose reduction efforts is sure to be fascinating, and you’ll be able to get a glimpse of that future at RSNA 2012, Nov. 25-30 in Chicago. This year’s theme is “Patients First,” which certainly lends itself to a robust discussion of dose reduction efforts.

If you can’t make it to RSNA yourself, be sure to check back with Health Imaging as we’ll be onsite covering the event live. You can have all of our RSNA coverage emailed to you by subscribing to our newsletter, and we’ll wrap our coverage with a follow-up in the January/February issue of Health Imaging magazine.

Evan Godt, staff writer