How does the radiology department do it? It uses Radiation Dose Intelligent Analytics for CT Examinations (RADIANCE), an open-source software package designed to facilitate dose monitoring, dose reporting, and quality assurance for CT exams, along with monthly scorecards.

RADIANCE was launched at RSNA 2010 in a presentation by Dr. Tessa Cook, PhD, a fourth-year radiology resident, and colleagues. At this session, Cook will discuss how its use with scorecards promotes regular review of CT exam dose estimates and stimulates protocol optimization.

The radiology department started using scorecards in the spring of 2011. They are generated for technologists, radiologists, section chiefs, and clinical administrators. The scorecards summarize average dose estimates for all interpreted or performed study types for the month for every radiologic technologist and radiologist. These scorecards also track the department's total for the month and the individual's scores for the prior month.

"At HUP, radiologists protocol every CT exam that is performed," Cook told AuntMinnie.com. "While we use standard protocols, one of our objectives is to customize these to the patient when it is appropriate to do so in order to deliver as low a dose as possible. We also want to ensure that the patient has the exam that best answers the clinical question, and it may not be the CT exam ordered -- or a CT exam at all."

To promote dose awareness and protocol optimization, the scorecards list the top 10 highest dose estimates overall. A free-text section allows users to explain the rationale for using a higher dose. Scorecard data may be configured in a variety of ways for review by section chiefs and administrators.

A hands-on course (RC454) on using RADIANCE is being conducted on Tuesday, November 29, from 4:30 p.m. to 6:00 p.m. in room S401AB.