%0 Journal Article
%T Use of BMI guidelines and individual dose tracking to minimize radiation exposure from low-dose helical chest CT scanning in a lung cancer screening program.
%A Manowitz A
%A Sedlar M
%A Griffon M
%A Miller A
%A Miller J
%A Markowitz S
%J Acad Radiol
%V 19
%N 1
%D Jan 2012
%M 22142680
%F 5.482
%R 10.1016/j.acra.2011.09.015
%X <B>OBJECTIVE: </B>The increasing use of computed tomography (CT) has been accompanied by rising concerns over potential radiation-related health risks, especially cancer, and a need to minimize such risks.<BR><B>METHODS: </B>We conducted 2186 low-dose helical chest CT scans among 1235 nuclear weapons workers at elevated risk of lung cancer, setting the CT scanner tube current at 30 mAs for all participants with BMI <35 kg/m(2) and permitting technologists to raise mAs levels for participants with BMI ≥35 kg/m(2). Dose-length product (DLP) was recorded from the CT scanner, permitting calculation of effective dose. Phantom-based estimates of effective dose were also made. A chest radiologist recorded acceptability of image quality.<BR><B>RESULTS: </B>The study population was significantly overweight: 79% exceeded a body mass index (BMI) >25 kg/m(2) and 37.1% exceeded a BMI ≥30 kg/m(2). Nearly 90% of CT scans were performed using a tube current setting of 30 mAs and had a mean DLP-based effective dose of 1.3 mSv. The phantom-based estimate of effective dose was lower at 1.1 mSv. Among participants with a BMI ≥35 kg/m(2), 92% were scanned at 40 or 50 mAs, which was associated with a DLP-based effective dose of 1.6 and 2.0 mSv, respectively. Image quality was satisfactory in 99.8% of scans.<BR><B>CONCLUSIONS: </B>Application of simple BMI-based guidelines and DLP tracking of low-dose helical chest CT scans in a lung cancer screening program minimizes radiation dose, even in a largely overweight population.