I came across an article from the Journal of the American College of Radiology on a number of recommendations for optimizing patient dose level in chest CT scans, the third most commonly performed CT exam in the country.

As the article points out, the lungs are an ideal organ for low dose radiation CT scans. Some of the recommendations offered include:

• Doctors should ensure that patients understand all instructions fully, including when to hold their breath and how much movement is permitted.
• Automated exposure control (AEC) techniques should be used as often as possible to assist with breathing in children and adults.
• Iterative reconstruction techniques reduce radiation dose exposure substantially and should be performed as often as possible.
• Centering patients in the gantry isocenter avoids excessive scan length dose. Additionally, CT scans should only be performed on the area of indication.
• Reading thicker sections ensures CT scan radiation risk reduction, while allowing fine details to be examined in nosier, thicker sections. This procedure should be utilized by imaging professionals.
• All CT scans should be done for a clinical and justifiable reason.

The tips and pointers in this article are all good tools for lowering patient radiation dose in chest CT. We have found that the use of iterative reconstruction is a big help – lowering dose by as much as 40%. Now that model based iterative reconstruction has recently become available in the USA (GE’s version is called VEO), we can look for dose reductions of more like 80%!