Evaluating an Image Gently and Image Wisely Campaign in a Multihospital Health Care System.
OBJECTIVE
The efficacy of an Image Gently(®)/Image Wisely(®) radiology departmental campaign consisting of the optimization of CT protocols to reduce dose while maintaining quality, and an educational effort to alter the ordering patterns of referring physicians at a multihospital academic center, was evaluated.


METHODS
The numbers of CT, MR, and ultrasound studies performed at inpatient, outpatient, and emergency facilities in the hospital system before and after the initiation of the departmental campaign (2010) were obtained for a 10-year period (2004-2014) using a radiology information system. For the same time period, dose per scan (volumetric CT dose index) was obtained through the Dose Index Registry(®)/National Radiology Data Registry for frequently performed studies. Descriptive statistics were used to analyze temporal trends in radiation dose and utilization across differing age groups: <20, 20 to 39, and 40 to 59 years.


RESULTS
The radiology information system yielded 865,879 imaging examinations and 4,508,030 patients. Although patient and imaging volume grew annually over the study period (by 6.8% and 4.9%, respectively), CT utilization as a percentage of total imaging decreased, compensated for by an increase in ultrasound use. This was most marked in the youngest age group. MR use as a percentage of total imaging was unchanged. The median volumetric CT dose index for each study protocol was reduced or stabilized.


CONCLUSIONS
The campaign resulted in a reduction in CT utilization, a reduction in radiation dose per study, and a compensatory rise in ultrasound use. An interactive aggressive educational campaign directed toward referring providers combined with protocol dose reduction efforts can be successful in reducing patient exposure from medical radiation.
Albert Einstein College of Medicine, Bronx, New York.
Kevin
K
Fernandes
Department of Radiology, Montefiore Medical Center, Bronx, New York. Electronic address: tlevin@montefiore.org.
Terry L
TL
Levin
Department of Radiology, Montefiore Medical Center, Bronx, New York.
Todd
T
Miller
Department of Radiology, Montefiore Medical Center, Bronx, New York.
Alan H
AH
Schoenfeld
Department of Radiology, Montefiore Medical Center, Bronx, New York.
E Stephen
ES
Amis
D003952:Diagnostic Imaging / Q000706:statistics & numerical data*; D006293:Health Promotion / Q000706:statistics & numerical data*; D006801:Humans; D009518:New York; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000517:prevention & control / Q000706:statistics & numerical data*; D011835:Radiation Protection / Q000379:methods / Q000706:statistics & numerical data*; D011871:Radiology / Q000193:education*
Image Gently; Image Wisely; Medical radiation; computed tomography; dose