Impact of active dose management on radiation exposure and image quality in computed tomography: An observational study in 1315 patients

Purpose To determine the clinical impact of CT dose management team on radiation exposure and image quality. Methods 2026 clinical routine CT examinations of 1315 patients were evaluated retrospectively. A CT dose management team was established as an integral part of the radiological department. It identified 5 CT protocols (A–E), where national reference values were exceeded the most. Those reference values included specifically the mean volumetric CT dose index (CTDIvol) and the mean dose-length product (DLP). Baseline data (period 1) and follow up data (period 2) were obtained after reduction of tube voltage and increase of pitch or noise index. Signal-to-noise ratios (SNR) and contrast-to-noise ratios (CNR) were calculated to compare image quality. Two-sided t-tests were performed. Results Mean CTDIvol and mean DLP of the chest protocol (A) decreased after reduction of tube voltage (P 0.05). SNR (protocol A) was significantly higher in period 2 (P Conclusions Establishing an operating dose management team as a standard for good clinical practice helps to considerably reduce CT radiation dose while preserving image quality.