Patient dose: implementation of a clinical practice assessment in medical imaging

Purpose. To describe our experience with the implementation of a clinical practice assessment (CPA) with regards to radiation exposure in CT. Methods. Such a CPA requires that a reference level be available (DRL: diagnostic reference level) along with exposure data (CTDI(vol) and DLP) allowing for the evaluation of current practices, development of,in action plan for improvement and future follow-up after implementation. Results. The action plan for improvements was elaborated based on the review of 641 radiation exposure data points collected over 1 year (CTDI(vol) and DLP). These data were compared to DRL values of corresponding anatomical regions. The implementation of dose guidelines enabled continuous quality improvement as opposed to punctual radiation dose assessments. Conclusion. The requirement of recording patient exposure was an excellent opportunity to perforin a CPA activity as described by the Haute Autorite de Sante (HAS) in its clinical audit process.