Optimisation of patient radiation dose in computed tomography.

Abstract

After decades of clinical use, diagnostic ultrasound has an enviable record for safety. However, under certain circumstances diverse biologic effects have been observed which may lead to risk. Therefore, the 'prudent' (i.e. justified and optimised) use is of ethical importance. Guidelines for prudent use of ultrasound are particularly important because its use is increasing, as is the range of ultrasound intensities. General safety guidelines have been provided by several professional bodies to define prudent use. However, these guidelines are often too theoretical to be of direct use. More practical advice is available in the literature but this is somewhat dispersed. It is therefore essential that a set of systemic practical guidelines be set up by every ultrasound department. Although in Malta many diagnostic ultrasound examinations are carried out every day, no such guidelines exist. This research project was designed to provide local ultrasound users with a set of practical guidelines for prudent use. The study also discusses the possible problems that may arise in implementing the proposed guidelines in the Maltese situation. Potential problems identified were the low level of awareness of the possible deleterious bioeffects of ultrasound, the lack of continuous education, the absence of knowledge regarding machine outputs and the absence of bioeffect risk indicators (particularly thermal and mechanical indices) on the machines in use.