Evaluating the impact of dose monitoring software alerts on radiation dose reduction in computed tomography: A systematic review

Mohammed Alanazi; Peter Kench; Seyedamir Taba; Ernest Ekpo

doi:10.1016/j.ejrad.2024.111892

Evaluating the impact of dose monitoring software alerts on radiation dose reduction in computed tomography: A systematic review

Eur J Radiol. 2024 Dec 18:183:111892. doi: 10.1016/j.ejrad.2024.111892. Online ahead of print.

Authors

Mohammed Alanazi¹, Peter Kench², Seyedamir Taba³, Ernest Ekpo⁴

Affiliations

¹ Medical Image Optimisation and Perceptions Group, Discipline of Medical Imaging Science, Faculty of Medicine and Health, The University of Sydney, Australia; Department of Radiology Sciences, Faculty of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia. Electronic address: mohammed.alanazi@sydney.edu.au.
² Medical Image Optimisation and Perceptions Group, Discipline of Medical Imaging Science, Faculty of Medicine and Health, The University of Sydney, Australia. Electronic address: peter.kench@sydney.edu.au.
³ Medical Image Optimisation and Perceptions Group, Discipline of Medical Imaging Science, Faculty of Medicine and Health, The University of Sydney, Australia. Electronic address: amir.tavakoli@sydney.edu.au.
⁴ Medical Image Optimisation and Perceptions Group, Discipline of Medical Imaging Science, Faculty of Medicine and Health, The University of Sydney, Australia. Electronic address: ernest.ekpo@sydney.edu.au.

PMID: 39718305
DOI: 10.1016/j.ejrad.2024.111892

Abstract

Introduction: Radiation Dose Monitoring Software (DMS) tools have been developed to monitor doses and alert computed tomography (CT) users of high radiation exposure. However, the causal factors for alerts and the impact of DMS in dose optimisation are poorly understood.

Aim: This review aims to identify high-dose CT examinations triggering alerts and their determinants, and to assess if the alerts from DMS help to reduce CT dose levels.

Methods: To identify relevant articles published to December 2023, an electronic search of Medline, Scopus, CINAHL, Embase, and the Web of Science was undertaken. Reference lists of published articles were also assessed to identify further articles. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was employed to evaluate articles for relevance. Articles were included if they used the DMS tool to detect high-dose events that issued alerts in CT and were published in English.

Results: The search resulted in 83 articles, of which, nine were included after a thorough screening process. High dose alerts most often occurred in CT chest, CT head/brain, CT Chest/abdomen/pelvis, and CT abdomen/pelvis with alert percentages ranging from 1.45% to 10.21%, 1.54% to 4.18%, 4.48% to 6.60%, and 4.47% respectively. Alerts were mainly triggered by overweight patients, scan repetition, miscentering of the patients, extra CT study added, orthopaedic hardware in the scanning area and scanning beyond the desire anatomy. Most of the studies reviewed show that DMS tools played a role in reducing the number of high-dose events that trigger alerts.

Conclusion: DMS tools are valuable in automatically identifying high-dose CT protocols, enabling quick investigation and dose optimisation. The high-dose events occurred due to patient and technical factors, which can be mitigated through proper monitoring and investment in both technological resources and staff training.

Keywords: Computed Tomography; Dose Alerts; Dose Monitoring Software; Dose Notifications; Radiation Protection; Radiation Reduction.

Publication types

Review