title: Radiation dose management in thoracic CT: an international survey.
abstract: OBJECTIVE
  We aimed to examine current practice patterns of international thoracic radiologists regarding radiation dose management in adult thoracic computed tomography (CT) examinations.
  
  
  METHODS
  An electronic questionnaire was sent to 800 members of five thoracic radiology societies in North America, Europe, Asia, and Latin America addressing radiation dose training and education, standard kVp and mAs settings for thoracic CT, dose reduction practices, clinical scenarios, and demographics.
  
  
  RESULTS
  Of the 800 radiologists, 146 responded to our survey. Nearly half (66/146, 45% [95% confidence interval, 37%-53%]) had no formal training in dose reduction, with "self-study of the literature" being the most common form of training (54/146, 37% [29%-45%]). One hundred and seventeen (80% [74%-87%]) had automatic exposure control, and 76 (65% [56%-74%]) used it in all patients. Notably, most respondents (89% [84%-94%]) used a 120 to 125 kVp standard setting, whereas none used 140 kVp. The most common average dose-length-product (DLP) value was 150 to 249 mGy.cm (75/146, 51% [43%-59%]), and 59% (51%-67%) delivered less than 250 mGy.cm in a 70 kg patient. There was a tendency towards higher DLP values with multidetector-row CT. Age, gender, and pregnancy were associated more with dose reduction than weight and clinical indication.
  
  
  CONCLUSIONS
  Efforts for reducing patient radiation dose are highly prevalent among thoracic radiologists. Areas for improvement include reduction of default tube current settings, reduction of anatomical scan coverage, greater use of automatic exposure control, and eventually, reduction of current reference dose values. Our study emphasizes the need for international guidelines to foster greater conformity in dose reduction by thoracic radiologists.
authors.affiliation: Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. francescomolinari.dr@gmail.com
authors.forename: Francesco
authors.initials: F
authors.lastname: Molinari
authors.forename: Denis M
authors.initials: DM
authors.lastname: Tack
authors.forename: Philip
authors.initials: P
authors.lastname: Boiselle
authors.forename: Long
authors.initials: L
authors.lastname: Ngo
authors.forename: Christina
authors.initials: C
authors.lastname: Mueller-Mang
authors.forename: Diana
authors.initials: D
authors.lastname: Litmanovich
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Bankier
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D038622:Internationality; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011247:Pregnancy; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods / Q000706:statistics & numerical data*; D013902:Radiography, Thoracic / Q000379:methods / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000706:statistics & numerical data*