U.S. Diagnostic Reference Levels and Achievable Doses for 10 Pediatric CT Examinations.

Background Diagnostic reference levels (DRLs) and achievable doses (ADs) were developed for the 10 most commonly performed pediatric CT examinations in the United States using the American College of Radiology Dose Index Registry. Purpose To develop robust, current, national DRLs and ADs for the 10 most commonly performed pediatric CT examinations as a function of patient age and size. Materials and Methods Data on 10 pediatric (ie, patients aged 18 years and younger) CT examinations performed between 2016 and 2020 at 1625 facilities were analyzed. For head and neck examinations, dose indexes were analyzed based on patient age; for body examinations, dose indexes were analyzed for patient age and effective diameter. Data from 1 543 535 examinations provided medians for AD and 75th percentiles for DRLs for volume CT dose index (CTDIvol), dose-length product (DLP), and size-specific dose estimate (SSDE). Results Of all facilities analyzed, 66% of the facilities (1068 of 1625) were community hospitals, 16% (264 of 1625) were freestanding centers, 9.5% (154 of 1625) were academic facilities, and 3.5% (57 of 1625) were dedicated children's hospitals. Fifty-two percent of the patients (798 577 of 1 543 535) were boys, and 48% (744 958 of 1 543 535) were girls. The median age of patients was 14 years (boys, 13 years; girls, 15 years). The head was the most frequent anatomy examined with CT (876 655 of 1 543 535 examinations [57%]). For head without contrast material CT examinations, the age-based CTDIvol AD ranged from 19 to 46 mGy, and DRL ranged from 23 to 55 mGy, with both AD and DRL increasing with age. For body examinations, DRLs and ADs for size-based CTDIvol, SSDE, and DLP increased consistently with the patient's effective diameter. Conclusion Diagnostic reference levels and achievable doses as a function of patient age and effective diameter were developed for the 10 most commonly performed CT pediatric examinations using American College of Radiology Dose Index Registry data. These benchmarks can guide CT facilities in adjusting pediatric CT protocols and resultant doses for their patients. © RSNA, 2021 An earlier incorrect version appeared online. This article was corrected on October 29, 2021.

U.S. PET/CT and Gamma Camera Diagnostic Reference Levels and Achievable Administered Activities for Noncardiac Nuclear Medicine Studies.

Existing surveys of radiopharmaceutical doses for U.S. nuclear medicine laboratories are of limited scope and size. Dose data are important because they can be used to benchmark individual laboratories, understand geographic variations in practice, and provide source data for societal guidelines and appropriateness criteria. Diagnostic reference levels (DRLs) and achievable administered activities (AAAs) for 13 noncardiac adult gamma camera and PET/CT examinations were derived retrospectively from American College of Radiology accreditation data (January 1, 2015, to December 31, 2017). The calculated DRL and AAA are consistent with previously published surveys. The distributions of radiopharmaceutical doses across facilities are in general consistent but show variation within a particular examination. Analysis of dose distribution suggests this variation results from differences in clinical protocols, educational gaps, and/or equipment factors. The AAA for the surveyed facilities exceeds dose ranges proposed in societal practice guidelines for several common nuclear medicine studies. Compared with similar surveys from Europe and Japan, geographic variation is observed, with some doses greater and others lower than used in the United States. Overall, radiopharmaceutical dose variation within the United States and internationally, and deviation from societal guidelines, imply that these dose-related benchmarks may be used to further standardize and improve clinical practice.

Radiological findings of abnormalities associated with congenital Zika virus infection: conclusions from World Radiology Day 2016

[ABSTRACT]. In July 2015, Brazil reported an association between Zika virus infection and Guillain-Barré syndrome, and then in October 2015, between Zika and microcephaly. Most countries and territories in the Region of the Americas were later affected by the virus, creating a public health emergency. Each year, the Pan American Health Organization (PAHO), Regional Office of the World Health Organization commemorates World Radiology Day (WRD), which highlights the role of radiology in public health. In 2016, PAHO devoted its WRD efforts to the Zika infection. Experts and partners presented and discussed the various radiological findings of Zika infection, the crucial role of obstetric ultrasound in the screening and monitoring of abnormalities associated with confirmed Zika virus infection, and the appropriateness of utilizing other neuroimaging technologies to study brain abnormalities in neonates and infants with prenatal Zika virus infection. The conclusions of WRD 2016 recommend that upon confirmation, prenatal ultrasound be used as the main tool to investigate and monitor suspected cases, with subsequent multidisciplinary postnatal assessments that include neuropediatric clinical studies and relevant neuroimaging. Additionally, radiology technicians should be adequately trained and a quality assurance program should be implemented to ensure timely, safe, and accurate diagnosis.

[RESUMEN]. En julio del 2015, Brasil informó una asociación entre la infección por el virus del Zika y el síndrome de Guillain-Barré y luego, en octubre 2015, entre la infección por el virus del Zika y la microcefalia. Posteriormente, la mayoría de los países y territorios de la Región de las Américas se vio afectada por el virus, lo que dio lugar a una emergencia de salud pública. Todos los años, la Organización Panamericana de la Salud (OPS), la Oficina Regional de la Organización Mundial de la Salud, conmemora el Día Mundial de la Radiología, en el que se reconoce la importancia de la radiología en la salud pública. En el 2016, la OPS dedicó las actividades en el marco del Día Mundial de la Radiología a la infección por el virus del Zika. Diversos expertos y asociados presentaron los distintos signos radiográficos de la infección por el virus del Zika, y debatieron sobre esto, así como sobre el papel fundamental que desempeñan las ecografías obstétricas en el tamizaje y el seguimiento de las anomalías asociadas con la infección por el virus del Zika confirmada, y sobre la pertinencia de utilizar técnicas de neurodiagnóstico por imágenes para estudiar las anomalías cerebrales en recién nacidos y lactantes con infección por el virus del Zika prenatal. Las conclusiones del Día Mundial de la Radiología del 2016 recomiendan que, tras la confirmación de la infección, se utilicen las ecografías prenatales como herramienta principal para investigar y hacer un seguimiento de los casos presuntos, seguida por una evaluación posnatal multidisciplinaria en la que se incluyan estudios clínicos neuropediátricos y las técnicas de neurodiagnóstico por imágenes pertinentes. Además, se debe capacitar adecuadamente a los técnicos de radiología y se debe ejecutar un programa de garantía de la calidad para asegurar el diagnóstico oportuno, seguro y certero.

[RESUMO]. Em julho de 2015, o Brasil informou existir associação entre a infecção por vírus zika e síndrome de Guillain-Barré e, em outubro do mesmo ano, entre o vírus zika e microcefalia. A maioria de países e territórios na Região das Américas foi subsequentemente afetada pelo vírus, constituindo emergência de saúde pública. Todos os anos, a Organização Pan-Americana da Saúde (OPAS), Escritório Regional da Organização Mundial da Saúde (OMS) comemora o Dia Internacional da Radiologia destacando o papel da radiologia em saúde pública. Em 2016, a OPAS dedicou este dia à infecção por vírus zika. Especialistas e parceiros apresentaram e debateram os diversos achados radiológicos na infecção por vírus zika, o papel fundamental do exame de ultrassom obstétrico na detecção precoce e monitoramento de anomalias associadas à infecção confirmada e quando convém usar outras técnicas de neuroimagem para estudar as anomalias cerebrais nos recém-nascidos e lactentes com infecção pré-natal. O painel do Dia Internacional da Radiologia 2016 recomenda que, com a confirmação da infecção, o ultrassom pré-natal seja o principal método usado para investigar e monitorar os casos suspeitos, com subsequente avaliação pós-natal multidisciplinar incluindo estudos clínicos neuropediátricos e exames de neuroimagem. Além disso, o pessoal técnico em radiologia deve ser adequadamente capacitado e implantado um programa de garantia da qualidade para assegurar o diagnóstico preciso, seguro e oportuno.

U.S. Diagnostic Reference Levels and Achievable Doses for 10 Adult CT Examinations.

Purpose To develop diagnostic reference levels (DRLs) and achievable doses (ADs) for the 10 most common adult computed tomographic (CT) examinations in the United States as a function of patient size by using the CT Dose Index Registry. Materials and Methods Data from the 10 most commonly performed adult CT head, neck, and body examinations from 583 facilities were analyzed. For head examinations, the lateral thickness was used as an indicator of patient size; for neck and body examinations, water-equivalent diameter was used. Data from 1 310 727 examinations (analyzed by using SAS 9.3) provided median values, as well as means and 25th and 75th (DRL) percentiles for volume CT dose index (CTDIvol), dose-length product (DLP), and size-specific dose estimate (SSDE). Applicable results were compared with DRLs from eight countries. Results More than 46% of the facilities were community hospitals; 13% were academic facilities. More than 48% were in metropolitan areas, 39% were suburban, and 13% were rural. More than 50% of the facilities performed fewer than 500 examinations per month. The abdomen and pelvis was the most frequently performed examination in the study (45%). For body examinations, DRLs (75th percentile) and ADs (median) for CTDIvol, SSDE, and DLP increased consistently with the patient's size (water-equivalent diameter). The relationships between patient size and DRLs and ADs were not as strong for head and neck examinations. These results agree well with the data from other countries. Conclusion DRLs and ADs as a function of patient size were developed for the 10 most common adult CT examinations performed in the United States. © RSNA, 2017.

Radiological findings of abnormalities associated with congenital Zika virus infection: conclusions from World Radiology Day 2016.

In July 2015, Brazil reported an association between Zika virus infection and Guillain-Barre syndrome, and then in October 2015, between Zika and microcephaly. Most countries and territories in the Region of the Americas were later affected by the virus, creating a public health emergency. Each year, the Pan American Health Organization (PAHO), Regional Office of the World Health Organization commemorates World Radiology Day (WRD), which highlights the role of radiology in public health. In 2016, PAHO devoted its WRD efforts to the Zika infection. Experts and partners presented and discussed the various radiological findings of Zika infection, the crucial role of obstetric ultrasound in the screening and monitoring of abnormalities associated with confirmed Zika virus infection, and the appropriateness of utilizing other neuroimaging technologies to study brain abnormalities in neonates and infants with prenatal Zika virus infection. The conclusions of WRD 2016 recommend that upon confirmation, prenatal ultrasound be used as the main tool to investigate and monitor suspected cases, with subsequent multidisciplinary postnatal assessments that include neuropediatric clinical studies and relevant neuroimaging. Additionally, radiology technicians should be adequately trained and a quality assurance program should be implemented to ensure timely, safe, and accurate diagnosis.

En julio del 2015, Brasil informó una asociación entre la infección por el virus del Zika y el síndrome de Guillain-Barré y luego, en octubre 2015, entre la infección por el virus del Zika y la microcefalia. Posteriormente, la mayoría de los países y territorios de la Región de las Américas se vio afectada por el virus, lo que dio lugar a una emergencia de salud pública. Todos los años, la Organización Panamericana de la Salud (OPS), la Oficina Regional de la Organización Mundial de la Salud, conmemora el Día Mundial de la Radiología, en el que se reconoce la importancia de la radiología en la salud pública. En el 2016, la OPS dedicó las actividades en el marco del Día Mundial de la Radiología a la infección por el virus del Zika. Diversos expertos y asociados presentaron los distintos signos radiográficos de la infección por el virus del Zika, y debatieron sobre esto, así como sobre el papel fundamental que desempeñan las ecografías obstétricas en el tamizaje y el seguimiento de las anomalías asociadas con la infección por el virus del Zika confirmada, y sobre la pertinencia de utilizar técnicas de neurodiagnóstico por imágenes para estudiar las anomalías cerebrales en recién nacidos y lactantes con infección por el virus del Zika prenatal. Las conclusiones del Día Mundial de la Radiología del 2016 recomiendan que, tras la confirmación de la infección, se utilicen las ecografías prenatales como herramienta principal para investigar y hacer un seguimiento de los casos presuntos, seguida por una evaluación posnatal multidisciplinaria en la que se incluyan estudios clínicos neuropediátricos y las técnicas de neurodiagnóstico por imágenes pertinentes. Además, se debe capacitar adecuadamente a los técnicos de radiología y se debe ejecutar un programa de garantía de la calidad para asegurar el diagnóstico oportuno, seguro y certero.

Em julho de 2015, o Brasil informou existir associação entre a infecção por vírus zika e síndrome de Guillain-Barré e, em outubro do mesmo ano, entre o vírus zika e microcefalia. A maioria de países e territórios na Região das Américas foi subsequentemente afetada pelo vírus, constituindo emergência de saúde pública. Todos os anos, a Organização Pan-Americana da Saúde (OPAS), Escritório Regional da Organização Mundial da Saúde (OMS) comemora o Dia Internacional da Radiologia destacando o papel da radiologia em saúde pública. Em 2016, a OPAS dedicou este dia à infecção por vírus zika. Especialistas e parceiros apresentaram e debateram os diversos achados radiológicos na infecção por vírus zika, o papel fundamental do exame de ultrassom obstétrico na detecção precoce e monitoramento de anomalias associadas à infecção confirmada e quando convém usar outras técnicas de neuroimagem para estudar as anomalias cerebrais nos recém-nascidos e lactentes com infecção pré-natal. O painel do Dia Internacional da Radiologia 2016 recomenda que, com a confirmação da infecção, o ultrassom pré-natal seja o principal método usado para investigar e monitorar os casos suspeitos, com subsequente avaliação pósnatal multidisciplinar incluindo estudos clínicos neuropediátricos e exames de neuroimagem. Além disso, o pessoal técnico em radiologia deve ser adequadamente capacitado e implantado um programa de garantia da qualidade para assegurar o diagnóstico preciso, seguro e oportuno.

Radiological findings of abnormalities associated with congenital Zika virus infection: conclusions from World Radiology Day 2016 / Resultados radiológicos de las anomalías asociadas con la infección congénita por el virus del Zika: conclusiones del Día Mundial de la Radiología del 2016 / Achados radiológicos de anomalias associadas à infecção congênita por vírus zika: conclusões do Dia Internacional da Radiologia 2016

ABSTRACT In July 2015, Brazil reported an association between Zika virus infection and Guillain-Barré syndrome, and then in October 2015, between Zika and microcephaly. Most countries and territories in the Region of the Americas were later affected by the virus, creating a public health emergency. Each year, the Pan American Health Organization (PAHO), Regional Office of the World Health Organization commemorates World Radiology Day (WRD), which highlights the role of radiology in public health. In 2016, PAHO devoted its WRD efforts to the Zika infection. Experts and partners presented and discussed the various radiological findings of Zika infection, the crucial role of obstetric ultrasound in the screening and monitoring of abnormalities associated with confirmed Zika virus infection, and the appropriateness of utilizing other neuroimaging technologies to study brain abnormalities in neonates and infants with prenatal Zika virus infection. The conclusions of WRD 2016 recommend that upon confirmation, prenatal ultrasound be used as the main tool to investigate and monitor suspected cases, with subsequent multidisciplinary postnatal assessments that include neuropediatric clinical studies and relevant neuroimaging. Additionally, radiology technicians should be adequately trained and a quality assurance program should be implemented to ensure timely, safe, and accurate diagnosis.

RESUMEN En julio del 2015, Brasil informó una asociación entre la infección por el virus del Zika y el síndrome de Guillain-Barré y luego, en octubre 2015, entre la infección por el virus del Zika y la microcefalia. Posteriormente, la mayoría de los países y territorios de la Región de las Américas se vio afectada por el virus, lo que dio lugar a una emergencia de salud pública. Todos los años, la Organización Panamericana de la Salud (OPS), la Oficina Regional de la Organización Mundial de la Salud, conmemora el Día Mundial de la Radiología, en el que se reconoce la importancia de la radiología en la salud pública. En el 2016, la OPS dedicó las actividades en el marco del Día Mundial de la Radiología a la infección por el virus del Zika. Diversos expertos y asociados presentaron los distintos signos radiográficos de la infección por el virus del Zika, y debatieron sobre esto, así como sobre el papel fundamental que desempeñan las ecografías obstétricas en el tamizaje y el seguimiento de las anomalías asociadas con la infección por el virus del Zika confirmada, y sobre la pertinencia de utilizar técnicas de neurodiagnóstico por imágenes para estudiar las anomalías cerebrales en recién nacidos y lactantes con infección por el virus del Zika prenatal. Las conclusiones del Día Mundial de la Radiología del 2016 recomiendan que, tras la confirmación de la infección, se utilicen las ecografías prenatales como herramienta principal para investigar y hacer un seguimiento de los casos presuntos, seguida por una evaluación posnatal multidisciplinaria en la que se incluyan estudios clínicos neuropediátricos y las técnicas de neurodiagnóstico por imágenes pertinentes. Además, se debe capacitar adecuadamente a los técnicos de radiología y se debe ejecutar un programa de garantía de la calidad para asegurar el diagnóstico oportuno, seguro y certero.

RESUMO Em julho de 2015, o Brasil informou existir associação entre a infecção por vírus zika e síndrome de Guillain-Barré e, em outubro do mesmo ano, entre o vírus zika e microcefalia. A maioria de países e territórios na Região das Américas foi subsequentemente afetada pelo vírus, constituindo emergência de saúde pública. Todos os anos, a Organização Pan-Americana da Saúde (OPAS), Escritório Regional da Organização Mundial da Saúde (OMS) comemora o Dia Internacional da Radiologia destacando o papel da radiologia em saúde pública. Em 2016, a OPAS dedicou este dia à infecção por vírus zika. Especialistas e parceiros apresentaram e debateram os diversos achados radiológicos na infecção por vírus zika, o papel fundamental do exame de ultrassom obstétrico na detecção precoce e monitoramento de anomalias associadas à infecção confirmada e quando convém usar outras técnicas de neuroimagem para estudar as anomalias cerebrais nos recém-nascidos e lactentes com infecção pré-natal. O painel do Dia Internacional da Radiologia 2016 recomenda que, com a confirmação da infecção, o ultrassom pré-natal seja o principal método usado para investigar e monitorar os casos suspeitos, com subsequente avaliação pós-natal multidisciplinar incluindo estudos clínicos neuropediátricos e exames de neuroimagem. Além disso, o pessoal técnico em radiologia deve ser adequadamente capacitado e implantado um programa de garantia da qualidade para assegurar o diagnóstico preciso, seguro e oportuno.

Adult Gamma Camera Myocardial Perfusion Imaging: Diagnostic Reference Levels and Achievable Administered Activities Derived From ACR Accreditation Data.

PURPOSE: The aim of this study was to glean from accreditation surveys of US nuclear medicine facilities the in-practice radiopharmaceutical diagnostic reference levels (DRLs) and achievable administered activities (AAAs) for adult gamma camera myocardial perfusion imaging (MPI). METHODS: Data were collected from the ACR Nuclear Medicine Accreditation Program during one three-year accreditation cycle from May 1, 2012, to April 30, 2015. Data elements included radiopharmaceutical, administered activity, examination protocol, interpreting physician specialty, practice type, and facility annual examination volume. Facility demographics, DRLs, and AAAs were tabulated for analysis. RESULTS: The calculated DRLs and AAAs are consistent with previously published surveys, and they adhere to national societal guidelines. Facilities seeking ACR accreditation are nearly evenly split between hospital based with multiple gamma cameras and office based with single gamma cameras. The majority of facilities use single-day, low-dosage/high-dosage (99m)Tc-based protocols; a small minority use (201)TlCl protocols. Administered activities show a consistency across facilities, likely reflecting adoption of standard MPI protocols. CONCLUSIONS: This practice-based analysis provides DRL and AAA benchmarks that nuclear medicine facilities may use to refine gamma camera MPI protocols. In general, the protocols submitted for ACR accreditation are consistent with national societal guidelines. The results suggest that there may be opportunities to further reduce patient radiation exposure by using modified examination protocols and newer gamma camera software and hardware technologies.

Clinical implementation of the National Electrical Manufacturers Association CT Dose Check standard at ACR Dose Index Registry sites.

PURPOSE: The goal of the study was to determine if and how the National Electrical Manufacturers Association CT Dose Check standard has been implemented in clinical practice. METHODS: A survey was conducted of all sites participating in the ACR Dose Index Registry, using a web-based survey instrument, to determine whether respondents were aware of the CT Dose Check standard and the American Association of Physicists in Medicine (AAPM) recommendations for Dose Alert values, and if clinical sites had implemented it. RESULTS: A total of 170 responses were received, representing 37% (170/460) of surveys sent and 23% (170/734) of facilities participating in the ACR Dose Index Registry. Of responding facilities, 57.1% (96/168) were aware of the CT Dose Check standard, and 51.2% (86/168) were aware of the AAPM recommendations. At 44% (73/165) of responding facilities, at least 1 CT scanner with Dose Check capability was present. Of sites responding that they had at least 1 CT scanner with this capability, 57% (42/74) had implemented Dose Alerts, and 71% (30/42) had implemented Dose Notifications on CT scanners with the capability. Most responding sites were located in community hospitals (55.8%; 86/154). CONCLUSIONS: Although the National Electrical Manufacturers Association CT Dose Check standard and the AAPM recommendations for its use had been available for at least 2 years at the time of the survey, nearly half of the participating sites were not familiar with them. Education and outreach are needed if this tool is to be used effectively.

Curbing potential radiation-induced cancer risks in oncologic imaging: perspectives from the 'image gently' and 'image wisely' campaigns.

Medical imaging that uses ionizing radiation, such as CT, radiography, nuclear medicine, and fluoroscopy, is a cornerstone of the care of oncology patients and provides great benefit. Ionizing radiation at high doses is a known carcinogen.The exact degree of the risk of carcinogenesis from the lower doses of ionizing radiation used in medical imaging is less clear. The purpose of this review is to provide the oncology community with knowledge about the doses used in medical imaging, radiation-induced cancer risks from imaging, considerations to keep in mind when balancing imaging benefits and risks in pediatric and adult oncologic settings, dose reduction strategies, and the "Image Gently" and "Image Wisely" campaigns; the latter campaigns facilitate the translation of existing evidence into best practices for providers and patients.

Radiation protection and dose monitoring in medical imaging: a journey from awareness, through accountability, ability and action but where will we arrive?

Radiation awareness and protection of patients have been the fundamental responsibilities in diagnostic imaging since the discovery of x-rays late in 1895 and the first reports of radiation injury in 1896. In the ensuing years, there have been significant advancements in equipment that uses either x-rays to form images, such as fluoroscopy or computed tomography (CT), or the types of radiation emitted during nuclear imaging procedures (e.g., positron emission tomography [PET]). These advancements have allowed detailed and indispensable evaluation of a vast array of disorders. In fact, in 2001, CT and MRI were cited by physicians as the most significant medical innovations in the previous 3 decades. Rapid technological advancements in the last decade with CT, especially, have required imaging professionals to keep pace with increasingly complex technology to derive the maximum benefits of improved image acquisition and display techniques, in essence, the improved quality of the examination. It has also been challenging to fulfill the fundamental responsibilities of safety during this period of rapid growth (e.g., radiation protection, management of the risk of additional interventions driven by incidental findings, performing studies that were not indicated). The purpose of this paper is to define critical issues pertinent to ensuring patient safety through the appropriate assessment, recording, monitoring, and reporting of the radiation dose from CT.

The ACR/Society of Breast Imaging Resident and Fellowship Training Curriculum for Breast Imaging, updated.

The education committees of the ACR Commission on Breast Imaging and the Society of Breast Imaging have revised the resident and fellowship training curriculum to reflect the current state of breast imaging in the United States. The original curriculum, created by the Society of Breast Imaging in 2000, had been updated only once before, in 2006. Since that time, a number of significant changes have occurred in the way mammography is acquired, how adjunctive breast imaging methods are used, and how pathology is assessed. This curricular update is meant to reflect these and other changes and to offer guidance to educators and trainees in preparing those interested in providing breast imaging services.

Image Gently: progress and challenges in CT education and advocacy.

Significant progress has been made in radiation protection for children during the last 10 years. This includes increased awareness of the need for radiation protection for pediatric patients with international partnerships through the Alliance for Radiation Safety in Pediatric Imaging. This paper identifies five areas of significant progress in radiation safety for children: the growth of the Alliance; the development of an adult radiation protection campaign Image Wisely™; increased collaboration with government agencies, societies and the vendor community; the development of national guidelines in pediatric nuclear medicine, and the development of a size-based patient dose correction factor by the American Association of Physicists in Medicine, Task Group 204. However, many challenges remain. These include the need for continued education and change of practice at adult-focused hospitals where many pediatric CT exams are performed; the need for increased emphasis on appropriateness of pediatric imaging and outcomes research to validate the performance of CT studies, and the advancement of the work of the first pediatric national dose registry to determine the "state of the practice" with the final goal of establishing ranges of optimal CT technique for specific scan indications when imaging children with CT.

Approaches to promotion and implementation of action on Radiation Protection for children.

The Radiation Protection in Medicine conference, reviewed in this journal supplement, outlined nine strategies to promote radiation protection for patients. The Alliance for Radiation Safety in Pediatric Imaging has focused its work on three of those areas: creating awareness of the need and opportunities for radiation protection for children; developing open-source educational materials for medical professionals and parents on this critical topic for improved patient safety and communication; and lastly, advocating on behalf of children with industry, government and regulatory bodies to improve equipment design and safety features, standardisation of nomenclature and displays of dose reports across vendor platforms that reflect the special considerations of children.

ACR white paper on radiation dose in medicine: three years later.

The benefits of diagnostic imaging are immense and have revolutionized the practice of medicine. The increased sophistication and clinical efficacy of imaging have resulted in its dramatic growth over the past quarter century. However, the evolution of imaging has also resulted in a significant increase in the population's cumulative exposure to ionizing radiation and a potential increase in cancer risk. The ACR, an advocate for radiation safety since its inception in 1924, convened the ACR Blue Ribbon Panel on Radiation Dose in Medicine in 2006 and issued 37 recommendations for the College to address these issues. This report updates the status of these recommendations.

The ACR BI-RADS experience: learning from history.

The Breast Imaging Reporting and Data System (BI-RADS) initiative, instituted by the ACR, was begun in the late 1980s to address a lack of standardization and uniformity in mammography practice reporting. An important component of the BI-RADS initiative is the lexicon, a dictionary of descriptors of specific imaging features. The BI-RADS lexicon has always been data driven, using descriptors that previously had been shown in the literature to be predictive of benign and malignant disease. Once established, the BI-RADS lexicon provided new opportunities for quality assurance, communication, research, and improved patient care. The history of this lexicon illustrates a series of challenges and instructive successes that provide a valuable guide for other groups that aspire to develop similar lexicons in the future.

Image Gently Vendor Summit: working together for better estimates of pediatric radiation dose from CT.

OBJECTIVE: Medical physicists currently use two standardized phantoms to estimate CT patient radiation dose. This "one-size-fits-all" adult model results in underestimates of displayed pediatric CT radiation dose on the console of current CT scanners. The purpose of this article is to discuss the Alliance for Radiation Safety in Pediatric Imaging Vendor Summit. CONCLUSION: Stakeholders were invited to discuss the development of better estimates of pediatric patient radiation dose. These stakeholders agreed to partner to improve CT radiation dose estimates for children.