engleski

Acceptable quality dose (AQD) in CT dose optimization: Croatian multi-center study

Purpose Integration of clinical image quality with radiation dose optimization for CT. Materials and Methods The study included 951 patients scanned at four tertiary healthcare hospitals in Croatia (from Osijek, Rijeka, and Zagreb) in phase I (baseline, n= 483 CT) and phase 2 (post- optimization, n=563 CT). These included head CT for trauma (237), non-contrast head CT for acute stroke (197), routine chest CT (181), pulmonary nodules follow up CT (24), routine abdomen CT, (273) and kidney stone CT (39). Four radiologists assessed all CTs with a 4-point image quality scoring system (1= Unacceptable quality ; 2= Limited quality ; 3= Adequate quality ; 4= Greater than needed quality). AQD was estimated as described in a previous publication (https://www.ncbi.nlm.nih.gov/pubmed/25430807). Results In phase 2, there was a 16% increase in IQS 3 (Phase 1: 48%, 308/640 ; Phase 2: 64%, 360/563) and a 14% decrease in IQS 4 (Phase 1: 48%, 307/640 ; Phase 2: 34%, 194/563). This was accompanied by a decrease in median CTDIvol and DLP for routine abdomen CT, routine chest CT, non- contrast head CT for acute stroke, and kidney stone CT protocols in phase 2 compared to phase 1 for images with an IQS of 3. The maximum decrease in dose for images with IQS 3 was noted for kidney stone CT (89% ; phase 1, median DLP= 1139.9 mGy.cm ; phase 2, median DLP= 116.4 mGy.cm) and the lowest decrease was noted for routine abdomen CT (39.7% ; phase 1, median DLP= 854 mGy.cm ; phase 2, median DLP= 514.9 mGy.cm). Significance of the conclusions Integration of image quality scoring criteria and the concept of AQD resulted in indication based radiation dose and image quality optimization determination of protocols with higher-thannecessary image quality and, awareness and detection of opportunities for optimization.

computed tomography ; optimization ; aceptable quality dose

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