The Low Dose Expert Panel aims to generate proposals detailing how manufacturers can further develop their CT technology - and how users can adapt their procedures - to minimize CT dose. Another goal is to produce recommendations to guide vendors in their development of new dose reduction innovations. At the panel's first meeting in May, one of the key suggestions to arise concerned ways to increase clinical utilization of the many CT dose reduction technologies that are already available.

"Our aim is to reduce radiation exposure for all typical CT examinations below 2 mSv, which is as low as the average annual dose due to naturally occurring background radiation," said Sami Atiya, CEO of Computed Tomography at Siemens. "We are committed to doing everything we can to help our customers reduce doses in CT without compromising the diagnostic quality of the examination in any way. With this in mind, we want to work with experts to develop concrete proposals on dose reduction and, therefore, launched SIERRA."

Call to action

During its first round of discussions, the Low Dose Expert Panel identified several action items:

• The group agreed to establish and contribute to an international, multi-institutional dose registry, in order to establish a baseline of dose levels for the 10 most commonly performed CT exams. As a next step, the values obtained can help to establish reference doses, with the potential to dramatically lower radiation exposure in clinical practice.
• The participating institutions will share their CT scan protocols for the 10 most commonly performed examinations on a central web site as a first step to promote best practice sharing in the field.
• Siemens will develop a dedicated low dose educational programme, in close collaboration with the involved institutions. Trainers specializing in dose reduction technology will be available to work with customers to train personnel, optimize scan protocols and implement dose reduction procedures.

The panel will meet twice a year to discuss new ideas and investigate whether measures already agreed upon are having a positive impact. Siemens intends to use the discussions to spur the development of new features for its CT scanners and training programmes for its customers.

"I see users operating CT scanners in everyday applications without taking full advantage of the possibilities available to them to strike the optimal balance between image quality and radiation dose," said panel member Cynthia McCollough, a medical physicist from Mayo Clinic in Rochester, MN. "The answer, in my opinion, involves a significant amount of training across a wide range of areas. I want to see users at more and more institutions receive the advanced training they need in order to make best use of the options available, and this will be the main objective of my work on the panel."

Panel member Marilyn Siegel, from the Mallinckrodt Institute of Radiology in St Louis, MO, added: "We have made great advances in optimizing paediatric radiation doses, but dose reduction optimization remains a work in progress. Advances in technology and capabilities of CT scanners will continue to evolve and improve our ability to diagnose disease. These advances will mandate new scanning protocols and continuing education for users. By collaborating with industry, we can optimize CT scanning in children even further and continue to improve patient care."

The panel's members are:

• Hatem Alkadhi, University Hospital Zürich, Switzerland
• Christoph Becker, Ludwig Maximilian University, Germany
• Elliot Fishman, Johns Hopkins University, USA
• Donald Frush, Duke University, USA
• Jörg Hausleiter, German Heart Center Munich, Germany
• Willi Kalender, University of Erlangen, Germany
• Harold Litt, University of Pennsylvania, USA
• Cynthia McCollough, Mayo Clinic, USA
• Alec Megibow, NYU-Langone Medical Center, USA
• Michael Recht, NYU-Langone Medical Center, USA
• Dushyant Sahani, Harvard Medical School, Massachusetts General Hospital, USA
• U Joseph Schoepf, Medical University of South Carolina, USA
• Marilyn Siegel, Mallinckrodt Institute of Radiology, USA
• Aaron Sodickson, Brigham and Women's Hospital, USA
• Kheng-Thye Ho, Tan Tock Seng Hospital, Singapore