Decreasing Lens Irradiation on Brain Imaging: A Multi-CT Scanner Quality Improvement Project

Area of Science:

• Radiology
• Ophthalmology
• Medical Imaging

Background:

• Cataracts are a leading cause of blindness globally.
• Ionising radiation exposure is a known risk factor for cataract development.
• Non-contrast head CT scans pose a risk of radiation exposure to the lens.

Purpose of the Study:

• To improve lens exclusion during non-contrast head CT scans at Newham University Hospital.
• To assess compliance with Royal College of Radiologists (RCR) standards for lens protection.
• To evaluate the impact of radiographer re-education on lens exclusion practices.

Main Methods:

• A retrospective audit of non-contrast head CT scans was conducted.
• Scans for trauma and orbital imaging were excluded.
• Radiographer re-education focused on gantry tilt and patient positioning, followed by a reaudit.

Main Results:

• Lens exclusion compliance improved from 0% to 14.50% (p=0.005).
• Challenges included variability in practices, 'near misses,' time constraints, and staff turnover.
• Significant improvement was noted, though RCR standards were not fully met.

Conclusions:

• Enhancing lens exclusion during head CT scans is crucial for mitigating radiation risks.
• Radiographer education on gantry tilt and patient positioning significantly improves patient safety.
• Ongoing re-education and audits are necessary to optimize adherence and reduce lens radiation exposure.