Radiation Dose Considerations in Emergent Neuroimaging

Key points

Before the scan: the appropriate use of computed tomography imaging

The most important consideration in patient-centered management before the patient arrives in the CT scanner suite is the determination of the most appropriate imaging study for a given phase of a patient’s care. This is no longer simply part of best practices in patient care, but a legal requirement for reimbursement when providing diagnostic imaging services to Medicare patients. In 2014, the US Congress passed bill H.R. 4302, or the Protecting Access to Medicare Act of 2014 (PAMA), which

After the scan: monitoring radiation exposure from computed tomography imaging

Monitoring of patient radiation exposure from CT imaging is an important part of ensuring the success of the broader strategy for radiation exposure management. It should involve a multitiered approach spanning individual CT examinations up to the institutional patient population.⁶² The first tier should involve a review by the interpreting radiologist of the CT radiation report attached to each study on Picture archiving & communication system (PACS) to ensure the CTDI_vol does not deviate

Emerging computed tomography technologies: dual energy and multienergy spectral computed tomography

Dual energy and multienergy CT has yet to achieve widespread adoption, but ongoing research in this area has exposed significant opportunities for improved diagnostic capabilities in emergent CT neuroimaging. A review of potential applications for dual energy CT neuroimaging is provided as a reference.⁶⁴ Briefly, the diagnostic value of dual energy and multienergy spectral CT lies in the ability to differentiate materials based on their varied x-ray attenuation behavior as a function of x-ray

Summary

Although the benefits of obtaining and/or excluding a diagnosis often outweighs any theoretic risk of radiation exposure in the setting of acute, emergent neurologic conditions, radiation dose from medical imaging remains an important concern. The first step in a patient-centered approach to radiation dose management in emergent neuroimaging is to promote the appropriate use of emergent CT neuroimaging studies through CDS tools. Before the patient arrives in the scanner, a thoughtful approach