Societies Issue Statements on Cerebral Imaging and Radiation Dosing

November 1, 2009—The American Heart Association's scientific statement on recommendations for imaging of acute ischemic stroke was published in Stroke by Richard E. Latchaw, MD, et al on behalf of the association's Council on Cardiovascular Radiology and Intervention, Stroke Council, and the Interdisciplinary Council on Peripheral Vascular Disease (2009;40:3646-3678). The document surveys the current evidence for imaging the cerebral parenchyma, imaging the cerebral vasculature, and imaging of cerebral perfusion.

In related news, on October 30, the American Society of Neuroradiology and American College of Radiology released a statement on computed tomography (CT) protocols and radiation dose.

According to the statement, the recent US Food and Drug Administration's safety investigation of radiation overexposures during perfusion CT imaging to aid in the diagnosis and treatment of stroke highlights the importance of carefully evaluating protocols for all CT procedures relative to both radiation dose and image quality.

The societies outlined Actions to Minimize Patient Dose in CT:

• Together, the lead radiologist, lead CT technologist, and qualified medical physicist should design and review all new or modified protocol settings, to ensure that both image quality and radiation dose aspects are appropriate.
• Develop internal radiation dose thresholds during any new CT protocol design.
• If an estimated dose value is above the applicable threshold for any routine clinical CT exam, implement steps to ensure patient safety and reduce future risk.
• Institute a regular review process of all protocols to ensure that no unintended changes have been applied that may degrade image quality or unreasonably increase dose.
• Do not disable the CT dose estimate interface option; ensure that the dose information is displayed during the exam prescription phase.
• CT staff should maintain CT-specific continuing education that focuses on patient safety.
• Obtain American College of Radiology CT Accreditation for an independent check of a facility's personnel, imaging techniques, image quality, and dose.