title: CT Radiation: Key Concepts for Gentle and Wise Use.
abstract: Use of computed tomography (CT) in medicine comes with the responsibility of its appropriate (wise) and safe (gentle) application to obtain required diagnostic information with the lowest possible dose of radiation. CT provides useful information that may not be available with other imaging modalities in many clinical situations in children and adults. Inappropriate or excessive use of CT should be avoided, especially if required information can be obtained in an accurate and time-efficient manner with other modalities that require a lower radiation dose, or non-radiation-based imaging modalities such as ultrasonography and magnetic resonance imaging. In addition to appropriate use of CT, the radiology community also must monitor scanning practices and protocols. When appropriate, high-contrast regions and lesions should be scanned with reduced dose, but overly zealous dose reduction should be avoided for assessment of low-contrast lesions. Patients' cross-sectional body size should be taken into account to deliver lower radiation dose to smaller patients and children. Wise use of CT scanning with gentle application of radiation dose can help maximize the diagnostic value of CT, as well as address concerns about potential risks of radiation. In this article, key concepts in CT radiation dose are reviewed, including CT dose descriptors; radiation doses from CT procedures; and factors and technologies that affect radiation dose and image quality, including their use in creating dose-saving protocols. Also discussed are the contributions of radiation awareness campaigns such as the Image Gently and Image Wisely campaigns and the American College of Radiology Dose Index Registry initiatives.
authors.affiliation: From the Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (M.K.K.); and Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115 and Harvard Medical School, Boston, Mass (A.D.S., W.W.M.S.).
authors.forename: Mannudeep K
authors.initials: MK
authors.lastname: Kalra
authors.affiliation: From the Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (M.K.K.); and Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115 and Harvard Medical School, Boston, Mass (A.D.S., W.W.M.S.).
authors.forename: Aaron D
authors.initials: AD
authors.lastname: Sodickson
authors.affiliation: From the Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (M.K.K.); and Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115 and Harvard Medical School, Boston, Mass (A.D.S., W.W.M.S.).
authors.forename: William W
authors.initials: WW
authors.lastname: Mayo-Smith
mesh_terms: D000328:Adult; D019985:Benchmarking; D049628:Body Size; D002648:Child; D003952:Diagnostic Imaging / Q000379:methods; D004307:Dose-Response Relationship, Radiation; D004867:Equipment Design; D004869:Equipment Safety; D006801:Humans; D009381:Neoplasms, Radiation-Induced / Q000209:etiology / Q000517:prevention & control; D009928:Organ Specificity; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000009:adverse effects / Q000517:prevention & control / Q000592:standards; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control*; D011874:Radiometry / Q000592:standards; D012042:Registries; D012308:Risk Management; D012984:Software; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000523:psychology / Q000706:statistics & numerical data; D019564:Unnecessary Procedures / Q000009:adverse effects