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New Protocol Cuts Radiation Dose to Embolism Patients

New imaging protocol reduces radiation exposure by 20 percent without increasing false negatives

MONDAY, Jan. 25 (HealthDay News) -- Implementing a new protocol for the judicious use of ventilation-perfusion (V/Q) scanning and computed tomography pulmonary angiography (CTPA) in patients with suspected pulmonary embolism reduced patient radiation exposure by 20 percent without increasing the false-negative rate, according to a study in the February issue of the American Journal of Roentgenology.

Evan G. Stein, M.D., and colleagues from the Albert Einstein College of Medicine in Bronx, N.Y., conducted educational seminars for staff in the institution's radiology, nuclear medicine, and emergency medicine departments to introduce a new imaging protocol, under which, chest radiography would be done first and if normal would be followed by V/Q scanning. If the radiography were abnormal, it would be followed by CTPA.

The researchers found that CTPA examinations decreased from 1,234 in 2006 (before the seminars) to 920 in 2007 (after the seminars), while the number of V/Q scans increased from 745 to 1,216. The changed practice pattern reduced the mean effective radiation dose by 20 percent without any significant difference in the false-negative rate.

"The practice patterns of physicians changed in response to an educational intervention, resulting in a reduction in radiation exposure to emergency department patients with suspected pulmonary embolism without compromising patient safety," the authors write.

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