The ‘Image Gently’ campaign: increasing CT radiation dose awareness through a national education and awareness program

Goske, Marilyn J.; Applegate, Kimberly E.; Boylan, Jennifer; Butler, P; Callahan, Michael J.; Coley, Brian D.; Farley, Shawn; Frush, Donald P.; Hernanz‐Schulman, Marta; Jaramillo, Diego; Johnson, Neil; Kaste, Sue C.; Morrison, Gregory; Strauss, Keith J.; Tuggle, Nora

doi:10.1007/s00247-007-0743-3

Cited by 230 publications

(125 citation statements)

References 8 publications

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“…Some hypothesized reasons for this decline include increased media attention, the national educational campaign of Image Gently, [14][15][16] and clinical decision guidelines 17,18 that raised awareness for minimizing ionizing radiation exposure in children. Efforts to implement multiinstitutional standards and protocols to reduce variation in the prescribing of CT scans may decrease variability and improve overall care.…”

Section: Discussionmentioning

confidence: 99%

Variation in Utilization of Computed Tomography Imaging at Tertiary Pediatric Hospitals

et al. 2015

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BACKGROUND: Recent efforts have focused on reducing computed tomography (CT) imaging in children. Although published reports show variability in CT scanning for specific indications, an assessment of the effects of institutional factors (case-mix or hospital volume) on the rate of CT scanning for any indication is necessary to better understand variability across pediatric hospitals. METHODS:Data from 2009 to 2013 on inpatient, observation, and emergency department (ED) encounters were extracted from the Pediatric Health Information System. Chronological trends and institutional variability in CT scan rates were examined by using negative binomial regression models. Case-mix was adjusted by using All Patient Refined Diagnosis Related Groups and severity level.RESULTS: Thirty hospitals were included. There were 12 531 184 patient encounters and 701 644 CT scans resulting in a mean of 56 scans per 1000 encounters (range: 26-108). The most common scan types were head (60.1%) and abdomen/pelvis (19.9%). There was an inverse relationship between the CT scan rate and hospital volume (P = .002) and a direct relationship between the CT scan rates for inpatient/observation and ED encounters (P , .001). The rate of CT imaging decreased from 69.2 to 49.6 scans per 1000 encounters during the study period (P , .001). CONCLUSIONS:The overall use of CT imaging is decreasing, and significant variability remains in CT use across tertiary pediatric hospitals. Hospital volume and institutional-level practices account for a significant portion of the variability. This finding suggests an opportunity for standardization through multi-institutional quality improvement projects to reduce CT imaging. WHAT'S KNOWN ON THIS SUBJECT:Given the efforts to decrease the use of ionizing radiation in pediatric patients, there is significant variability in head computed tomography (CT) scan use in pediatric emergency departments for minor head trauma. WHAT THIS STUDY ADDS:This study characterized variability in CT scan rates for all body regions in emergency department, observation, and inpatient encounters across 30 tertiary pediatric hospitals. Two-fold variation remained after case-mix adjustment, with higher volume hospitals having lower rates of CT scanning.

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Section: Discussionmentioning

confidence: 99%

Variation in Utilization of Computed Tomography Imaging at Tertiary Pediatric Hospitals

et al. 2015

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“…Approaches like the use of bowtie filter and automated exposure control are now established practices in diagnostic CT. More recently, the 'Image Gently' [11] and 'Image Wisely' [12] campaigns have been initiated to increase awareness of the opportunities to lower radiation doses in the imaging of children and adults.…”

Section: Personalized Imaging In Igrtmentioning

confidence: 99%

Toward Personalized Imaging in Image-guided Radiotherapy

Zhang¹,

Deng

2014

Cancer Sci Res

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“…It is well understood that children have more radiosensitive tissues and organs, and longer life span for cancerous tumor to develop. Many efforts have been jointly contributed from medical physicists, radiologists, and technologists to raise awareness in pediatric imaging [2] . One remarkable effort was the founding of the Image Gently Campaign, which promotes the justification for and optimization of pediatric CT imaging.…”

Section: Introductionmentioning

confidence: 99%

Size dependence of inherent image quality of a 2nd generation dual source CT scanner

Zhang

Solomon

Samei

2015

IJDI

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The fast developing CT technologies have complicated the protocol optimization process. Since there are increasing numbers of free parameters that can be adjusted, it is imperative to know exactly how these parameters affect the image quality. This paper examines the effect of varying dose level, tube voltage, reconstruction methods and the AEC function on the CT image quality across different sizes. A size varying phantom, consisting of five cylindrical tiers, was used. To assess the image quality, task transfer function (TTF), noise power spectra (NPS), contrast, and detectability index was computed and compared across sizes. It was found that from small to large size, detectability increased more as the dose increased. When the CTDIvol increased from 0.7 to 22.6 mGy, the detectability for the smallest size section increased by four fold but increased by eight fold for the largest section. Low tube voltage exhibited superior detectability and contrast for all sections, especially for the small size sections, where detectability doubled for the smallest section when tube voltage decreased from 120 kV to 80 kV. TTF curves showed considerable dependence on size, but more pronounced dependence on reconstruction techniques. In conclusion, small size phantoms were affected very differently from large size phantoms by dose levels, reconstruction methods, and tube voltage selection. Low tube voltage and iterative reconstruction technique can deliver superior image quality for small patients. Due to beam hardening and substantially increased noise at low tube voltage for large patients, high tube voltage is still recommended for large patients to retain image quality.

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The ‘Image Gently’ campaign: increasing CT radiation dose awareness through a national education and awareness program

Cited by 230 publications

References 8 publications

Variation in Utilization of Computed Tomography Imaging at Tertiary Pediatric Hospitals

Variation in Utilization of Computed Tomography Imaging at Tertiary Pediatric Hospitals

Toward Personalized Imaging in Image-guided Radiotherapy

Size dependence of inherent image quality of a 2nd generation dual source CT scanner

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