The role of PACSs in enabling real-time dose monitoring for abdominal CT studies

To examine the effectiveness of Picture Archiving and Communication Systems in evaluating radiation dose variability across abdominal Computed Tomography protocols and explore dose differences on the basis of contrast usage and demographic factors.

A retrospective cross-sectional study was conducted at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia, using abdominal CT scan data archived in PACSs from January 2023 to December 2024. A total of 200 adult patients (100 males, 100 females) were included. Variables analyzed included CTDIvol, DLP, age, gender, clinical indication, scanner type, contrast usage, and CT protocols. Statistical analysis involved Mann-Whitney U and Kruskal-Wallis H tests, with a significance threshold of p < 0.05.

Contrast-enhanced scans demonstrated higher radiation doses compared with non-contrast scans. No significant gender-based differences were observed. Substantial variability in CTDIvol and DLP was found across nine abdominal CT protocols (CTDIvol: χ² = 141.93, p < 0.001; DLP: χ² = 120.89, p < 0.001), with CT urography and triphasic liver scans yielding the highest doses.

PACS-based dose monitoring demonstrates large variations in radiation exposure depending on contrast use and protocols. The inclusion of real-time dose monitoring through PACSs can improve protocol standardization and patient safety in radiology departments.