WG1 Synthesis Report (PDF – 1.1 Mb) - European Medical ALARA ...

WG 1 - SynthDoc revised 10-2012 22.10.2012WP 1 was included to underline the pivot impact of CT on medical exposures andthe resulting need for reduction of CT patient doses. As a direct consequence ofthe findings in WP 1, a review on CT risk / benefit – as provided in WP 2 for bothhealthcare and individual health assessment (opportunistic screening) - is imperative,since an appropriate risk / benefit assessment is a prerequisite for anyjustification of CT procedures. Concerning healthcare, it is concluded that a reliablebenefit-risk analysis of radiological imaging procedures has to be brokendown to diagnosis-related groups of patients, and it is recommended to launchresearch projects addressing these important issues. Concerning individualhealth assessment, it is underlined that - when some CT procedures, such as CTcolonography, are considered as an acceptable option for cancer screening -these CT procedures have to be embedded in a well-established screening algorithmand have to be properly quality assured along the whole screening chain,and that respective actions have to be initiated on a national and / or internationallevel. In addition, in WP 2, the strong interrelation between justification and optimisationfor the reduction of CT patient doses is addressed. Unfortunately, thereview indicate that actions initiated by international radiation protection organizationsand national regulators often show the tendency to suggest separate approachesto develop and consolidate both fundamental principles of medical radiationprotection.WPs 3 to 7 directly address the issue of optimisation of CT patient exposure. Thisis in particular valid for WPs 3 and 4, highlighting the impact of equipment andprotocols on CT dose reduction.WP 5 addresses a promising approach that may have a significant impact on CTpatient dose reduction and, as a consequence, on upcoming regulations on CT.The introduction of a dose efficiency parameter, that characterises CT scannerswith respect to image quality in relevant clinical scenarios, would facilitate decisionmaking when purchasing a new scanner, allow for a fair competition betweenmanufacturers, and enable to set the appropriate dose level in protocoloptimization.- 5 / 138 -