title: Standardization and optimization of CT protocols to achieve low dose.
abstract: The increase in radiation exposure due to CT scans has been of growing concern in recent years. CT scanners differ in their capabilities, and various indications require unique protocols, but there remains room for standardization and optimization. In this paper, the authors summarize approaches to reduce dose, as discussed in lectures constituting the first session of the 2013 UCSF Virtual Symposium on Radiation Safety and Computed Tomography. The experience of scanning at low dose in different body regions, for both diagnostic and interventional CT procedures, is addressed. An essential primary step is justifying the medical need for each scan. General guiding principles for reducing dose include tailoring a scan to a patient, minimizing scan length, use of tube current modulation and minimizing tube current, minimizing tube potential, iterative reconstruction, and periodic review of CT studies. Organized efforts for standardization have been spearheaded by professional societies such as the American Association of Physicists in Medicine. Finally, all team members should demonstrate an awareness of the importance of minimizing dose.
authors.affiliation: Department of Medicine, Division of Cardiology, Columbia University Medical Center and New York-Presbyterian Hospital, New York, NY.
authors.forename: Sigal
authors.initials: S
authors.lastname: Trattner
authors.affiliation: Department of Radiology, Columbia University Medical Center and New York-Presbyterian Hospital, New York, NY.
authors.forename: Gregory D N
authors.initials: GDN
authors.lastname: Pearson
authors.affiliation: Departments of Radiology and Biomedical Engineering, University of California, San Francisco.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Chin
authors.affiliation: Department of Imaging Physics, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Dianna D
authors.initials: DD
authors.lastname: Cody
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, MA.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Gupta
authors.affiliation: Departments of Radiology and Biomedical Engineering, University of California, San Francisco.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Hess
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, MA.
authors.forename: Mannudeep K
authors.initials: MK
authors.lastname: Kalra
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, MN.
authors.forename: James M
authors.initials: JM
authors.lastname: Kofler
authors.affiliation: Department of Radiology, University of California Los Angeles.
authors.forename: Mayil S
authors.initials: MS
authors.lastname: Krishnam
authors.affiliation: Department of Medicine, Division of Cardiology, Columbia University Medical Center and New York-Presbyterian Hospital, New York, NY.|Department of Radiology, Columbia University Medical Center and New York-Presbyterian Hospital, New York, NY.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Einstein
mesh_terms: D006283:Health Physics / Q000592:standards*; D017410:Practice Guidelines as Topic; D011829:Radiation Dosage; D011835:Radiation Protection / Q000592:standards*; D011856:Radiographic Image Enhancement / Q000592:standards*; D011871:Radiology / Q000592:standards*; D014057:Tomography, X-Ray Computed / Q000592:standards*; D014481:United States
keywords: CT; justification; optimization; radiation dose