title: A Comprehensive CT Dose Reduction Program Using the ACR Dose Index Registry.
abstract: OBJECTIVE
  The purpose of this article is to demonstrate the role of the ACR Dose Index Registry(®) (DIR) in a dose reduction program at a large academic health care system.
  
  
  METHODS
  Using the ACR DIR, radiation doses were collected for four common CT examination types (head without contrast, chest with contrast, chest without contrast, and abdomen and pelvis with contrast). Baseline analysis of 7,255 CT examinations from seven scanners across the institution was performed for the period from December 1, 2011, to March 15, 2012. A comprehensive dose reduction initiative was guided by the identification of targets for dose improvement from the baseline analysis. Data for 14,938 examinations from the same seven scanners were analyzed for the postimplementation period of January 1, 2013, to July 1, 2013.
  
  
  RESULTS
  The program included protocol changes, iterative reconstruction, optimization of scan acquisition, technologist education, and continuous monitoring with feedback tools. Average decrease in median dose-length product (DLP) across scanners was 30% for chest CT without contrast, 29% for noncontrast head CT, 26% for abdominal and pelvic CT with contrast, and 10% for chest CT with contrast. Compared with average median DLP in the ACR DIR, the median institution-wide CT DLPs after implementation were lower by 33% for chest CT without contrast, 32% for chest CT with contrast, 26% for abdominal and pelvic CT with contrast, and 6% for head CT without contrast.
  
  
  CONCLUSIONS
  A comprehensive CT dose reduction program using the ACR DIR can lead to substantial dose reduction within a large health care system.
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia. Electronic address: brent.p.little@emory.edu.
authors.forename: Brent P
authors.initials: BP
authors.lastname: Little
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia.
authors.forename: Phuong-Anh
authors.initials: PA
authors.lastname: Duong
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia.
authors.forename: Jessie
authors.initials: J
authors.lastname: Knighton
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia.
authors.forename: Kristen
authors.initials: K
authors.lastname: Baugnon
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia.
authors.forename: Erica
authors.initials: E
authors.lastname: Campbell-Brown
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia.
authors.forename: Hiroumi D
authors.initials: HD
authors.lastname: Kitajima
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia.
authors.forename: Steve
authors.initials: S
authors.lastname: St Louis
authors.affiliation: Department of Radiology, MD Anderson Cancer Center, Houston, Texas.
authors.forename: Habib
authors.initials: H
authors.lastname: Tannir
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia.
authors.forename: Kimberly E
authors.initials: KE
authors.lastname: Applegate
mesh_terms: D000005:Abdomen / Q000528:radiation effects; D000046:Academic Medical Centers; D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D008297:Male; D010388:Pelvis / Q000528:radiation effects; D058996:Quality Improvement; D011829:Radiation Dosage; D011834:Radiation Monitoring / Q000592:standards*; D011835:Radiation Protection / Q000379:methods*; D011860:Radiography, Abdominal / Q000592:standards; D013902:Radiography, Thoracic / Q000592:standards; D012042:Registries; D017751:Safety Management / Q000592:standards; D012955:Societies, Medical / Q000592:standards; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000592:standards*; D014481:United States
keywords: American College of Radiology; Ionizing radiation; dose reduction; dose registry; quality improvement