Sending dose reports for cardiac CT angiography by email to imaging staff resulted in significant overall dose reduction and a decrease in high-dose outliers, according to a study published in the August issue of Academic Radiology.
The study was conducted by Leif-Christopher Engel, M.D. and colleagues from Massachusetts General Hospital who, according to research published last August in the American Journal of Medicine, were able to reduce CCTA radiation dose by 74.8 percent over a six-year period by increasing the use of dose-saving measures and evolving scanner technology.
According to Engel, Mass General has demonstrated that, by carefully performing CCTA with "simple and widely available default protocol recommendations," radiologists can perform examinations with a median dose lower than an invasive diagnostic angiography or nuclear myocardial perfusion imaging.
Since there were still instances in which a small number of studies were performed with significantly higher doses, however, the hospital instituted a weekly dose report feedback system.
For this study, Engel and his colleagues analyzed 450 consecutive patients who underwent cCTA between April 2011 and January 2013--150 patients from the period before the weekly dose reports were started, and 150 after the dose reports were initiated. Then, to assess whether overall dose reductions were maintained over time, the results were compared to a control group consisting of another 150 patients whose exams were performed after the study period.
The researchers found that the total radiation dose was significantly lower both in the period after which the weekly dose reports were initiated (3.4 mSv) and in the late control group (3.3 mSv), compared to the period before the weekly dose reports began (4.1 mSv).
The number of high-dose outliers decreased, as well. Prior to the start of the weekly dose reports, 88 percent of the exams were less than 10 mSv. This increased to 97 percent after the dose reports were initiated, and 95.3 percent during the late control period.