Impact of Low-Dose Computed Tomography on Computed Tomography Orders and Scan Length

Curtis Simmons, James Milburn, Curtis Simmons, James Milburn

Abstract

Background: New techniques have reduced the radiation dose delivered from a computed tomography (CT) examination. These techniques do not affect the number of scans ordered, the number of phases in each examination, or the scan length, as these parameters are controlled by ordering providers and CT technologists. The purpose of this study was to determine if deploying low-dose CT resulted in an increase in radiation exposure because of more liberal ordering habits or more liberal scanning ranges. Methods: We identified the most frequent CT examination types through a retrospective study of billing data from 2013. A campaign for low-dose CT scans was implemented, and data from 2 months prior and 2 months after were collected (n=797; average age=51.0 years ± 20.5; range, 4 to 97 years) and analyzed for differences in radiation dose, overall area scanned, and number of phases requested using unpaired t tests. Results: According to the billing data, the largest category of CT scans was the abdominal CT (31% of all CT examinations). After the low-dose campaign was implemented, we observed no difference in the number of examination phases ordered (1.2 ± 0.5 vs 1.3 ± 0.6, P=0.15), no increase in length of the scan (45.1 ± 7.5 cm vs 43.7 ± 10. 4 cm, P=0.08), and an overall decrease in dose (1,069 ± 634 mGy*cm vs 676 ± 480 mGy*cm, P<0.001). Conclusion: A campaign alerting staff to the availability of low-dose CT did not cause an increase in CT examination ordering and did not impact the area scanned by technologists.

Keywords: Dose-response relationship–radiation; radiation exposure; radiology; retrospective studies; tomography–x-ray computed.

©2019 by the author(s); Creative Commons Attribution License (CC BY).

Figures

Figure.
Figure.
Histograms of size-specific dose estimate (SSDE) and computed tomography dose index (CTDI) volume by frequency before and after iterative reconstruction.

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