ABDOMINAL EXAMINATION IN KNH USING 16 MULTI-SLICE CT SCAN: REVIEW OF ALARA PRACTICE IN MANAGING PATIENT DOSE
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Objectives

 

To assess the justification of abdominal CT examinations carried out, quantify radiation dose and evaluate the optimization of scanning parameters that contribute to radiation dose determination within the ALARA principle in comparison to international standards.

 

Study design

 

Cross-sectional study.

 

Setting of study

 

Radiology department of Kenyatta National Hospital (KNH).

 

Subjects studied

 

76 patients aged between 20 and 65 years of age, who were referred for abdominal CT scanning at KNH’s Radiology Department were recruited through random sampling between July 2008 and March 2009.

 

Results of the study

 

18.4% of the examinations had a non-specific clinical indication and 26.3% of the CT findings did not support a clinical diagnosis.  The average E was five times higher than internationally published guidelines for abdominal scanning and within epidemiological concerns.

 

39.5% of the examinations were done with mismatched protocols. 

 

Specifity of the request and correct protocol matching were positively associated with supporting CT result to the clinical indication.

 

Conclusion

 

MDCT as a new and useful technology in medical imaging is providing technical challenges to end users that compromise optimization in reducing patient dose, from Kenyatta National Hospital’s experience.  Local protocol practice was shown not only to have had an impact on the dose but also to have influenced the diagnostic yield of the examinations.  Further Quality Assurance practices are needed.  This highlighted the fact that with regard to dose reduction, justification for the examination appears to be the main component of ALARA that clinicians and radiologists can take advantage of.