A Comprehensive CT Dose Reduction Program Using the ACR Dose Index Registry

Little, Brent P.; Duong, Phuong-Anh T.; Knighton, Jessie; Baugnon, Kristen L.; Campbell-Brown, Erica; Kitajima, Hiroumi D.; Louis, Steve St.; Tannir, Habib; Applegate, Kimberly E.

doi:10.1016/j.jacr.2015.07.020

Cited by 20 publications

(8 citation statements)

References 24 publications

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“…Therefore, all the radiation use in medical imaging, including fluoroscopic procedures, must be measured and managed [ 21 ] because of the carcinogenic effects of radiation exposure. Many registries and suggestions from both radiologic and cardiovascular societies were announced [ 15 ] [ 14 ] [ 22 ] [ 23 ]. However, gastroenterologists seem less interested in this issue than other medical societies, such as radiologists and cardiologists [ 15 ] [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Radiation exposure dose and influencing factors during endoscopic retrograde cholangiopancreatography

et al. 2018

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IntroductionVarious endoscopic procedures under fluoroscopic guidance are being rapidly adopted, and radiation exposure is considered to be increasing. However, there is little concern about this issue in gastroenterology practice. This study aims to evaluate the actual radiation exposure dose (RD) during endoscopic retrograde cholangiopancreatography (ERCP) and the factors affecting the RD.MethodsIn this retrospective, single-center cohort study of 1157 consecutive patients who underwent ERCP between October 2012 and February 2017, we analyzed the influences of patient characteristics, procedure time (min), total fluoroscopy time (min), type of processing engine, experience of the endoscopist, and type of disease on the total RD (mGy).ResultsThe median procedure times were 28 min for common bile duct stones (CBDS), 25 min for distal malignant biliary obstruction (MBO), and 30 min for proximal MBO. Similarly, the median fluoroscopy times were 10.3, 8.8, and 13.4 min, and the median RDs were 167, 123, and 242 mGy, respectively. Proximal MBO required significantly longer procedure time and fluoroscopy time and resulted in greater RD than distal MBO (P = 0.0006, <0.0001, <0.0001) and CBDS (P = 0.015, <0.0001, <0.0001). Multiple linear regression showed that distal MBO and a novel processing engine negatively correlate with RD (P = 0.04, <0.0001) and that proximal MBO positively correlates with RD (P = 0.0001).DiscussionProcedure time and fluoroscopy time were significantly longer for proximal MBO than for CBDS and distal MBO. The type of disease and processing engine significantly influenced the RD during ERCP.

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Section: Discussionmentioning

confidence: 99%

Radiation exposure dose and influencing factors during endoscopic retrograde cholangiopancreatography

et al. 2018

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“…85 Thus, formal radiation safety training and ongoing quality audits are 2 cornerstones of radiation protection of both patients and staff. Although the diagnostic radiology and interventional cardiology communities have implemented radiation safety programs and guidelines to the training curriculum, [86][87][88][89][90] no such equivalent is currently in place for the interventional endoscopy community. In 1 recent survey among therapeutic endoscopy fellows, 91.7% of respondents believed that formal education to operate their hospital's fluoroscopy system and to reduce radiation exposure would have been beneficial, yet 78.6% reported they had received no such formal training and did not know how to modulate settings to reduce radiation doses.…”

Section: Promoting Radiation Safety and Quality In Gi: Now And In The Futurementioning

confidence: 99%

American Society for Gastrointestinal Endoscopy radiation and fluoroscopy safety in GI endoscopy

Kwok

Hasan

Duloy

et al. 2021

Gastrointestinal Endoscopy

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“…DMS have been used for many years now, especially for CT installations, and from the experience gained so far it is obvious that they are powerful tools in the quest of optimization. A large amount of experience on the use and the benefits of such systems was gained by the American College of Radiology (ACR) Dose Index Registry (DIR) which is operating since 2011 [67,76,80,81]. According to the information found in its website (https://www.acr.org/Practice-Management-Quality-Informatics/Registries/Dose-Index-Registry), as of April 2018 there were 2100 facilities connected to the DIR, with more than 50 million exams collected.…”

Section: Dose Monitoring Systems As Optimization Toolsmentioning

confidence: 99%

Radiation dose monitoring in computed tomography: Status, options and limitations

et al. 2020

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In the last few years there has been an increasing interest on radiation dose to patients undergoing various diagnostic or therapeutic procedures with the use of ionizing radiation. Especially for CT examinations and interventional procedures, where it is known that patient doses are much higher than conventional radiography, new norms have been published that require to have appropriate radiation dose indices registered in the patient medical record. Because of these demands, dose monitoring has been recommended and adopted into many clinical practices as a routine procedure for every patient and every examination. Dedicated dose monitoring systems (DMS) that facilitate data collection and processing, statistical comparisons, reporting and management of radiation dose related information have been devised and are being used worldwide. In this review paper, a brief flashback to the reasons that necessitated dose monitoring in radiology will be first presented. Furthermore, since the focus of this manuscript is on CT, the CT dosimetry principles and metrics will be summarized. The limitations of these metrics will be also discussed, so that DMS users are aware of the semantics of the parameters shown in the DMS reports. The operation of DMS systems will be outlined to make users aware of functions, limitations, and available options of DMS systems. Furthermore, the usefulness of DMS systems as an optimization tool will be presented and discussed. Finally, information about the DMS solutions available in the market and relevant links will be presented.

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A Comprehensive CT Dose Reduction Program Using the ACR Dose Index Registry

Cited by 20 publications

References 24 publications

Radiation exposure dose and influencing factors during endoscopic retrograde cholangiopancreatography

Radiation exposure dose and influencing factors during endoscopic retrograde cholangiopancreatography

American Society for Gastrointestinal Endoscopy radiation and fluoroscopy safety in GI endoscopy

Radiation dose monitoring in computed tomography: Status, options and limitations

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