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1/11 #UnsolicitedArticleReview
Authors link radiology leadership prioritizing CT protocol teams with dose reduction amounts. Awesome paper!
https://doi.org/10.1016/j.jacr.2020.01.044
@JACRJournal @aapmHQ @ctisus @CtSpectral @SABImaging @EFOMP_org @RadiologyACR @UCRadSafety @ahraonline @ASRT
Authors link radiology leadership prioritizing CT protocol teams with dose reduction amounts. Awesome paper!
https://doi.org/10.1016/j.jacr.2020.01.044
@JACRJournal @aapmHQ @ctisus @CtSpectral @SABImaging @EFOMP_org @RadiologyACR @UCRadSafety @ahraonline @ASRT
2/11 Authors sent surveys to profile 100 site's CT practice culture, and obtained a snap shot of the actual dose via pulling it from the site's dose monitoring system
3/11 Site's agreeing strongly that they had department leadership supporting dose optimization had ~12% average dose reduction and ~47% fewer high dose events.
4/11 ~50/100 centers in the survey had CT Optimization Teams. The majority of sites were academic and all but one institution were academic. I think its critical to understand how academic community can port lessons out to the real world.
@UWiscRadiology https://uwgect.wiscweb.wisc.edu
@UWiscRadiology https://uwgect.wiscweb.wisc.edu
5/11 Navel gazing best describes the paper's citations, so I'll do the same here plus give a link to a great paper from Mayo/MD Anderson 
https://doi.org/10.1016/j.jacr.2013.10.013 (pay wall)
http://metodonline.ir/wp-content/uploads/2017/10/radiologymanagement20161112-dl.pdf-1796541847.pdf#page=21 (free)
https://doi.org/10.1120/jacmp.v16i2.5023 (free)
https://doi.org/10.1016/j.jacr.2013.10.013 (pay wall)
http://metodonline.ir/wp-content/uploads/2017/10/radiologymanagement20161112-dl.pdf-1796541847.pdf#page=21 (free)
https://doi.org/10.1120/jacmp.v16i2.5023 (free)
6/11 I tell sites the best thing they can do is sit down tech and rad and discuss workflow. I've NEVER observed a case where there were no misconceptions between these groups. The authors kicked out tech survey responses if they also got a rad response. Rose tinted glasses?
7/11 My go to paper to cite to relate clinical impact to CT Protocol Team effort has been from @drjsiegelman and @DustinGress (link below) paper on dropping head repeats. This Smith-Bindman paper fills a similarly important role.
https://doi.org/10.1016/j.jacr.2012.12.008
https://doi.org/10.1016/j.jacr.2012.12.008
8/11 We should consider the cost of CT protocol optimization...
http://metodonline.ir/wp-content/uploads/2017/10/radiologymanagement20161112-dl.pdf-1796541847.pdf#page=21
http://metodonline.ir/wp-content/uploads/2017/10/radiologymanagement20161112-dl.pdf-1796541847.pdf#page=21
9/11 And even if your site has the money, does the radiology community have people trained in this? Who's curriculum covers the ins and outs of contrast protocols? ... crickets. Every vendor's AEC system is a Blackbox. Physics residencies have no core competencies on this stuff.
10/11 Physicists should be key to protocol optimization, but this is VERY rare. Passing state regs, ACR, TJC is why we exist. Most academic physicists think model observers are the answer, lol, its been a decade since IR recon and they can't decide on CHO or NPW...
11/11 Review turned into rant over. Read the paper, its a great contribution to our field.
https://doi.org/10.1016/j.jacr.2020.01.044
https://doi.org/10.1016/j.jacr.2020.01.044
