The University of California Dose Optimization and Standardization Endeavor
Despite a dramatic increase in the use of computed tomography (CT) imaging in the last decade, there are few concrete standards for how CT examinations should be conducted. Without explicit standards, CT radiation doses by protocol and indication are highly variable both within and across institutions. For example, a patient may go to a hospital or clinic with a particular symptom, and if a CT scan is ordered, the dose of radiation they receive may be 20 times higher (or lower) depending on where they are scanned. While there are understandable reasons for some of this variation, much of it is unexplained explained.
The focus of the UC DOSE grant is to create a collaborative working group of radiologists, physicists, and CT technologists across the UC Medical Centers. The collaborators will focus on the safety of CT by assessing the doses we are currently using for CT imaging (across a broad range of indications) and by determining which protocols use the least radiation within particular clinical settings. Using the dose distribution data and protocol settings from the five UC sites, the research team will better understand how to minimize doses. Standardizing protocols will help to reduce the dose variability patients are exposed to both within and across sites. The aim is to reduce radiation exposure to patients while maintaining diagnostic efficacy of the exams. In addition, the collaborators are developing measures that can be used to assess the safety of current practice, and they are also developing educational materials that will improve radiation safety within UC and more broadly within the US.
Click to visit the Radiology Outcomes Research Laboratory website to learn more about the UCDOSE Project.
The California Legislature passed a bill (Senate Bill 1237) in 2010 to require health care providers to collect and record CT radiation dose information in the medical record. The bill required adherence starting July 1, 2012, earning national attention. As part of the bill, physicists must now verify CT radiation doses to ensure that overexposures do not occur. To comply with this new law, hospitals must develop methods to incorporate CT dose information in the patient medical record. This is a dramatic change from current practice -- and centers are scrambling to understand what to report and how to report it. The challenge is both to comply with the law and to provide information in a meaningful fashion. As part of the UC DOSE grant, investigators have developed a model approach that institutions can follow in order to comply with SB1237.
Click to download a copy of the UCDOSE SB1237 Guidance Document.
UC DOSE Virtual Symposium (2013):
The UC DOSE Virtual Symposium on Radiation Safety and Computed Tomography is available on-demand until May 2014, and focuses on educational efforts to optimize CT radiation dose. The curriculum is offered to physicians, technologists, physicists, nurses, medical students, and individuals who want to understand the issues regarding CT radiation dose. The course is offered not only within the UCMCs, but also to a broad national and international audience.
Structurally, virtual conferences are appealing since they offer an educational experience while cutting travel costs for attendees. Separate halls at the conference include professional-produced lectures, discussions on new legislation and professional oversight surrounding radiation, discussions on radiation risk communication to patients, discussions of dose registries, presentations by advocacy groups, a CT simulation "CTSim", and vendor rooms demonstrating different dose acquisition software.
Click to join the UC DOSE mailing list and stay updated about the conference.