Current CT Practice in Germany: Results and Implications of a Nationwide Survey

• Published in: European journal of radiology Vol. 90; pp. 114 - 128
• Main Authors: Schegerer, Alexander A, Nagel, Hans-Dieter, Stamm, Georg, Adam, Gerhard, Brix, Gunnar
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.05.2017
• Subjects: Clinical CT practice; Computed tomography; German nationwide survey; Germany; Humans; Modern CT technology; Patient exposure; Practice Patterns, Physicians' - statistics & numerical data; Protocol optimization; Radiation Dosage; Radiology; Radiometry - statistics & numerical data; Surveys and Questionnaires; Tomography Scanners, X-Ray Computed - statistics & numerical data; Tomography, X-Ray Computed - statistics & numerical data; computed tomography; Clinical CT practice; spiral mode; DE; tube current modulation; dual energy techniques; pitch-corrected CT dosis index; dose length product; Protocol optimization; CT examinations; D eff; IR; DLP; iterative image reconstruction; Modern CT technology; German nationwide survey; effective dose; CT; CTDI vol; abbrevations of CT examinations are given in Table 1; SM; Patient exposure; TCM; Deff; CTDIvol; Computed tomography
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2017.02.021

Abstract Purpose To assess patient doses and relative frequencies of standard CT examinations performed in Germany in 2013/14 as well as the effect of modern CT technology on patient exposure. Methods All known CT facilities in Germany were requested to complete a questionnaire on the frequency of 34 examinations and the respective parameter settings used. Taking into account type-specific properties of each scanner, effective doses were estimated for each reported examination. The mean and the percentiles of the CT dose index, scan length, dose length product, and effective dose were determined for each type of examination. Results According to the data provided for about 11% of all medical CT scanners operated in 2013/14, the effective dose was 4.6/5.9 mSv per scan/examination. The effective dose was significantly reduced by about 15% compared to the CT practice before 2010. Modern CT technology, such as tube current modulation and iterative image reconstruction reduced the effective dose significantly by 6% and 13%, respectively. The mean effective dose applied at scanners produced by different manufacturers differed by 25%, at maximum. Conclusion Patient exposure was reduced substantially in recent years. There is, however, still a considerable potential for further dose reduction by adapting scan protocols to the medical purpose and by a consequent exploitation of modern CT technologies.