Radiation Dose Reduction in Coronary Computed Tomography Angiography.

BACKGROUND: Coronary computed tomography angiography (CCTA) is an American Heart Association/American College of Cardiology Class Ia diagnostic test for chest pain evaluation, but radiation exposure limits its use. PROJECT RATIONALE: By applying the Nuclear Regulatory Commission's "as low as reasonably achievable" principle and streamlining workflows using patient-specific scanning protocols, radiation dose can be reduced without sacrificing diagnostic accuracy. PROJECT SUMMARY: At The University of Texas Medical Branch satellite campus, we implemented standardized patient-specific computed tomography (CT) scanner protocols with a goal of reducing patient radiation and improving image quality. Comparison of pre- and postintervention scans from 146 patients revealed that the median radiation dose decreased by 63.4% (19.4 vs 7.1 mSv; P < 0.0001), with a greater decrease in women and a higher body mass index-to-dose correlation after intervention. TAKE-HOME MESSAGES: Standardized, patient-specific protocols for CCTA substantially reduce radiation dose. Implementing effective interventions requires understanding CT scanner capabilities, using vendor support, and maintaining consistent feedback loops between the imaging physician and the CT technologist.