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Published on: September 11, 2011
Optimization of computed tomography urography protocol, 1997 to 2008: effects on radiation dose
P Dahlman1, L Jangland, M Segelsjö
1Department of Radiology, Uppsala University Hospital, Uppsala, Sweden. par.dahlman@radiol.uu.se
Acta Radiologica (Stockholm, Sweden : 1987)
|March 25, 2009
Summary
Computed tomography (CT) urography protocols were updated between 1997 and 2008, significantly reducing patient radiation exposure. Mean effective dose decreased by 60%, demonstrating improved safety in urinary tract imaging.
Area of Science:
- Radiology
- Medical Imaging
- Radiation Dosimetry
Background:
- Computed tomography (CT) urography has become the standard for uroradiology, largely replacing excretory urography.
- This shift has led to an overall increase in patient radiation dose.
Purpose of the Study:
- To analyze CT urography protocol modifications from 1997 to 2008.
- To determine the impact of these protocol changes on mean effective patient dose.
Main Methods:
- A retrospective study of 102 patients undergoing CT urography for suspected urinary tract malignancy.
- Patients were grouped by protocol changes implemented at five distinct time points.
- Mean effective doses were calculated using the ImPACT CT Patient Dosimetry Calculator.
Main Results:
- Reducing scan phases from four to three in 1999 lowered the mean effective dose.
- Adapting mAs settings to patient size in 2001 further decreased radiation exposure.
- Implementation of automatic tube current modulation (CARE Dose and CARE Dose4D) between 2005 and 2008 progressively reduced mean effective doses, despite adjustments for image quality.
Conclusions:
- CT urography protocols have evolved, leading to a substantial decrease in patient radiation dose.
- The mean effective dose was reduced by 60% between 1997 and 2008.
- Protocol optimization enhances patient safety in diagnostic uroradiology.
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