title: Reducing emergency CT radiation doses with simple techniques: A quality initiative project.
abstract: BACKGROUND
  Use of indication-specific CT protocols and adjustment of scan parameters to decrease radiation exposure may result in significant dose reduction. We implemented these strategies and compare pre- and post-implementation radiation dose in emergency department (ED) patients.
  
  
  METHODS
  This was a descriptive, retrospective study. Patients older than 15 years who had undergone emergency CT examinations of the head, chest, abdomen, pelvis and abdominopelvic region in periods before and after dose-reduction implementation were included. The primary outcome was volume CT dose index (CTDIvol ) and dose length products (DLP).
  
  
  RESULTS
  There were 786 studies in the pre-implementation (group 1) and 955 studies in the post-implementation (group 2) periods. Radiation dose from all CT types significantly reduced in the post-implementation period. Average CTDIvol for head, chest, abdomen, pelvis and abdominopelvic region (doses during pre-implementation period in parentheses) were 51.5 (109), 8.1 (30.4), 13.1 (41.8), 11 (38), 11.2 (41.8) mGy, respectively. Average DLP was also significantly lower (pre-implementation dose in parentheses) in all CT types, which were 943 (2232), 324 (2517), 944 (5605), 280 (4024), 809 (7118) mGy●cm, respectively. Patients' age, gender, body mass index and size were not significantly different between the two groups. Image quality decreased but almost all examinations received an acceptable diagnostic subjective image quality.
  
  
  CONCLUSIONS
  Simple methods could help significantly reduce CT radiation exposure in ED patients while maintaining an acceptable level of diagnostic image quality.
authors.affiliation: Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital Mahidol University, Bangkok, Thailand.
authors.forename: Chakkarat
authors.initials: C
authors.lastname: Sulagaesuan
authors.affiliation: Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital Mahidol University, Bangkok, Thailand.
authors.forename: Nitima
authors.initials: N
authors.lastname: Saksobhavivat
authors.affiliation: Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital Mahidol University, Bangkok, Thailand.
authors.forename: Sawwanee
authors.initials: S
authors.lastname: Asavaphatiboon
authors.affiliation: Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital Mahidol University, Bangkok, Thailand.
authors.forename: Rathachai
authors.initials: R
authors.lastname: Kaewlai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004632:Emergency Medical Services / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061214:Patient Safety / Q000706:statistics & numerical data; D058996:Quality Improvement; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000032:analysis / Q000517:prevention & control* / Q000706:statistics & numerical data*; D011835:Radiation Protection / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D011874:Radiometry / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D013785:Thailand / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: computed tomography; emergency radiology; radiation dose