Less is more

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So far, the theme of this year has been “reduction.” We’ve seen our ability to access credit reduced, we’ve scrutinized our stock-based retirement accounts as they reduce their value, and we’ve seen our friends and neighbors suffer as a result of workforce reduction. However, not all reducing is bad.

Radiation dose reduction is an extremely good thing, particularly if doing so does not affect the interpretative quality of a diagnostic image. Three seminal studies have been published this month demonstrating that turning down the kilovoltage improves the quality of care without affecting quality of diagnosis.

The Journal of the American Medical Association this week released the results of a state-wide study in Michigan that cut the kVp for coronary CT angiography (CCTA) from 120 to 100, if the patient’s weight was normal. In combination with ECG gating and beta blocker administration, clinicians were able to decrease radiation dose by an average of 53.3 percent for nearly 5,000 patients—without a decrease in diagnostic image quality.

The June issue of the American Journal of Roentgenology also took a look at dose reduction for pulmonary CTA to rule out pulmonary embolism. Clinicians at Brigham and Women’s Hospital in Boston turned down the kVp from 120 to 100 and reported an average 44 percent reduction of estimated effective dose, with no significant difference in image quality. They also found that vascular enhancement was better at a lower kVp.

The June edition of Radiology explored lowering the kVp to increase tumor conspicuity and reduce cumulative radiation exposure in patients with liver cancer undergoing serial contrast-enhanced CT exams. Researchers at Duke University Medical Center in Durham, N.C., found that a low tube voltage, high tube current protocol significantly increases the conspicuity of malignant hypervascular liver tumors during the late hepatic arterial phase, while simultaneously reducing the patient radiation dose.

In other news, if you or your group is interested in finding out more about the capabilities of CT technology and how it can extend and expand the reach of your diagnostic imaging service lines, head over to our Healthcare TechGuide and check out the variety of systems offered there.

Lastly, if you have a comment or report to share about the utilization of CT in your practice, please contact me at the address below. I look forward to hearing from you.

Jonathan Batchelor, Web Editor