The main results of our study were the following; The 10 hospitals studied did not have an information sheet of patients on the use of X-rays at the CT scanner room and the notion of patient radiation protection during an examination; Regarding the use of dose reduction software, 75% of medical imaging technicians had not given the correct answer; One-third of practitioners had benefited from patient radiation protection training during their academic training. All questions asked to radiologists were favorable.
This study shows that efforts should be provided for improving clinical practice in medical imaging services in our hospitals. The use of these software during an exam can reduce the dose. Manufacturers offer these technologies not only to sell their device better but also to protect patients against the harmful effects of ionizing radiation. The balance between the dose and the quality of the image is this during an imperative in medical imaging. The particular attention we carried to the low dose is no longer enough. Our efforts must now focus on a good understanding of the ideal dose. The right dose is the reasonable balance between applied radiation, image quality and patient care. In order to help customers achieve this balance, Siemens Healthineers has introduced CARE Right. To help customers achieve this balance, Siemens offers Care Right that is based on three aspects: technology for an ideal dose, ideal dose levels and ideal dose management 1. For some time now, iterative reconstruction has been a promising method of sensitive reduction of the dose without compromising on image quality. For innovation in the iterative reconstruction for obtaining an ideal dose, Siemens proposes Admire (Advanced Modelled Iterative Reconstruction), SAFIRE (Sinogram affirmed Iterative Reconstruction) that makes it possible to take advantage of iterative reconstruction while reducing the dose up to at 60%. Surpasses even that offered IRIS (Iterative Reconstruction in Image Space). Iris also provides excellent image quality at a reduced dose. Several other techniques are utised to reduce the dose to the scanner. CARE DOSE 4D makes it possible to adapt the dose according to the anatomy of the patient and its position during the acquisition. Care KV automatically determines the appropriate voltage and acquisition parameters to obtain the ideal dose for the relevant review and user-defined image quality 1.
The CT Scanner is the most significant contributor to radiation dose on radiological examination, although the frequency of the examination is far below other modalities 16. In order to control this radiation dose, manufactures of CT Scan have equipped their units with built-in software called Automatic Exposure Control (AEC). Sari et al showed the use of CARE Dose 4D software reduced dose of up to 54.34% while maintaining image quality. CARE Dose 4D (Siemens Healthineers, Erlangen, Germany) comprises a series of dose-saving technologies in which the tube current is adapted according to patient size, shape and density, whilst maintaining a user-defined reference image quality 17. CARE Dose 4D provides the following: adaptation of mAs according to patient size based on the topogram (scout scan); angular modulation of the tube current to reflect patient shape; and z-modulation of the tube current to reflect patient shape (topogram-based modulation in a more fine-tuned manner). Computed tomography (CT) systems routinely use automatic exposure control (AEC), which modulates the tube current. However, for optimal use, there are several aspects of an AEC system that need to be considered. When optimising the CT radiation dose and image quality, the projection angle of the localiser, patient centring, protocol selection, scanning direction and the use of protective devices requires special attention 18. Toshiba, Philips and General Electric (GE) use software such as Sure Exposure, Care Right and Auto or Smart mA to reduce the dose absorbed to the CT scanner like Siemens.
The manipulation of CT scanner in medical imaging services should be taken seriously. Each manipulator must master the technology present in the CT scanner it uses on a daily basis. Each CT scanner to its specificity in dose reduction procedures. A medical imaging technician who does not master the software on the CT scanner that he uses on a daily basis will always work with the acquisition parameters proposed by the CT scanner. Which will lead to patients from non-optimized doses. Training on CT scanner technology installed in your service will allow medical imaging technicians to better contribute to dose optimization during an examination.