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Conclusions of Today Round Table Conference Radiology Patient Dose Ir. Edward Smit Director of the Departement Health and Environment Brussels June 26th, 2010

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Conclusions (1/4) Largest contribution to average radiation dose from medical diagnostics and treatment to Belgian citizen

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Conclusions (2/4) National DRLs have been established and communicated. These DRL will be used as reference for further optimization and reduction of dose levels Procedure for obtaining dose data will be improved (new data entry sheets, future on-line service) List of examinations has been screened and proposal for changes have been made. Suggestions for fine tuning have been made today Incorporation of feedback by combined working group during September and October Working group will take into account today's feedback to make final adjustments in procedure, data sheets and list of examinations Improvements will be implemented by end of October 2010

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Conclusions (3/4) Next step is optimization phase to further reduce national DRLs. Dr. Tack demonstrated impressive results (30%- 66% dose reduction) for CT scan optimization in Luxemburg. Opportunity in Belgium to optimize below P75 towards P25 Special protocols for pediatric CT by all centers surveyed. Use of ATM, manual mA and kV reduction. Registered dose (DRL) underestimate real dose DAP can be used to estimate effective dose and skin dose

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Conclusions (4/4) Authorities demand reduction of unnecessary examinations Better justification of examinations Adaptation of financing from fee for service to fee for result.. Good cooperation between FOD VG, FANC, RIZIV and medical sector to obtain structural changes Actions to radiological centers that do not report patient dose