Real-time CT dose monitoring reduces errors, improves technologist awareness

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When Triemli Hospital in Zurich, Switzerland, decided to install dose management software for its CT scanners, Christina Heilmaier, MD, and her colleagues wanted to find out just how effective the software could be at reducing elevated dosage notifications and raising technologist awareness through real-time monitoring.

“Dose management software provides detailed dose data on completion of the acquisition, allowing CT technologists to immediately review the reasons for the dose notifications when dose has exceeded predefined thresholds,” they wrote in study results published in the May issue of the  American Journal of Roentgenology. “In addition to the dose notifications, dose management software provides a size-specific dose estimate, provides information about patient centering, and includes a patient-specific dose history of the previous months.”

Heilmaier and her team analyzed dose data of the two scanners—a clinical routine CT scanner used primarily for outpatient procedures, and an emergency CT scanner used mainly for emergency department and ICU patients—before and after implementation of the dose management software. Radiology technologists were instructed to perform real-time monitoring by checking for elevated dose notifications after each examination.

Their results showed a significant reduction in dose notifications by nearly half (210 versus 120, respectively) in the time period immediately following implementation, with fewer reported errors such as patient miscentering occurring after the dose management software was installed.

“The total number of notifications was significantly lower [after implementation of real-time monitoring] on the emergency CT scanner and on the clinical routine CT scanner as well as on both scanners together,” the authors wrote. “Real-time monitoring of patient dose with dose management software increases CT technologists' dose awareness and leads to a reduced number of dose notifications due to human error,” the authors concluded.