CT SURVEY

1. INTRODUCTION

The HSE has a legal obligation under Statutory Instrument 478 (2002) to collect and publish statistics on population dose levels from the use of medical ionising radiation on an annual basis. In 2010 the HSE completed a population dose survey for Computed Tomography (CT), which established that CT contributes 55% of the population dose from medical exposures in Ireland. One response per holder is essential. Where a holder has multiple locations a response per location is requested.
To assist in calculation of median dose, included in the email is a excel file attachment, that can be used. Users may enter their raw data and median dose result is calculated for entry into the survey. Closing date for completion of this survey is 26 May 2017.

Population Dose: This section is mandatory: Part 1 of this survey will update the information on population dose from CT for 2016. It is expected, based on data published from other countries, that the contribution of CT to population dose may have increased.

Diagnostic Reference Levels: Part 2 of this survey is optional, and is designed to update the National Diagnostic Reference Levels for CT examinations. This survey is requesting data on Clinical DRLs based on clinical indications, rather than anatomical area. Clinical DRLs take into account that the same image quality, and dose, is not required for all imaging of the same anatomical area.

Recent information on Clinical DRLs can be found at the following link; European Congress of Radiology
http://ecronline.myesr.org/ecr2017/index.php?p=recorddetail&rid=abca5869-6cfc-4a24-af6d-f2fb34501941

E-learning on Radiation Dose Management in CT is freely available from the IAEA

http://ns-files.iaea.org/training/rpop/ct-e-learning/story_html5.html

Question Title

* 1. Name of Organisation:

Name:

Email:

Telephone Number:

Question Title

* 2. EPA Licence Number:

Question Title

* 3. Contact for Clinician with responsibility for radiation safety of the patient in CT, if different from the Practitioner in Charge:

Name:

Email:

Telephone Number:

Question Title

* 4. Contact details of person submitting information:

Name:

Email:

Contact Phone Number:

Question Title

* 5. CT Scanner Details:

Room:

Make:

Model:

Year of Installation:

Where install year is unknown please enter approximate age of scanner:

Dose modulation is installed:

Iterative Reconstruction Installed:

Both dose modulation and iterative Recon installed:

Question Title

* 6. CT Scanner Details:

Room:

Make:

Model:

Year of Installation:

Where install year is unknown please enter approximate age of scanner:

Dose modulation is installed:

Iterative Reconstruction is installed:

Both dose modulation and iterative Recon installed:

Question Title

* 7. CT Scanner Details:

Room:

Make:

Model:

Year of Installation:

Where install year is unknown please enter approximate age of scanner:

Dose modulation is installed:

Iterative Reconstruction is installed:

Both Dose modulation and iterative Recon installed:

Question Title

* 8. CT Scanner Details:

Room:

Make:

Model:

Year of Installation:

Where install year is unknown please enter approximate age of scanner:

Dose modulation is installed:

Iterative Reconstruction is installed:

Both Dose modulation and iterative Recon installed:

Question Title

* 9. State the total Number of CT Patients per Annum scanned in 2016:

Total Patients:

Male:

Female:

Other:

Question Title

* 10. Do you Scan:

	Yes	No
Adult Patients (16+)	Adult Patients (16+) Yes	Adult Patients (16+) No
Paediatrics	Paediatrics Yes	Paediatrics No
Both	Both Yes	Both No

Question Title

* 11.
Does your Dose Data get transferred automatically to your PACS?

Yes

Other (please specify)

Question Title

* 12.
Female Adults: Scanner 1: BRAIN

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 13.
Female Adults: Scanner 2: BRAIN

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 14.
Female Adults: Scanner 3: BRAIN

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 15.
Female Adults: Scanner 4: BRAIN

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 16.
Male Adults: Scanner 1: BRAIN

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 17.
Male Adults: Scanner 2: BRAIN

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 18.
Male Adults: Scanner 3: BRAIN

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 19.
Male Adults: Scanner 4: BRAIN

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 20.
Female Adults: Scanner 1: CERVICAL SPINE

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 21.
Female Adults: Scanner 2: CERVICAL SPINE

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 22.
Female Adults: Scanner 3: CERVICAL SPINE

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 23.
Female Adults: Scanner 4: CERVICAL SPINE

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 24.
Male Adults: Scanner 1: CERVICAL SPINE

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 25.
Male Adults: Scanner 2: CERVICAL SPINE

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 26.
Male Adults: Scanner 3: CERVICAL SPINE

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 27.
Male Adults: Scanner 4: CERVICAL SPINE

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 28.
Female Adults: Scanner 1: HI RES THORAX

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 29.
Female Adults: Scanner 2: HI RES THORAX

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 30.
Female Adults: Scanner 3: HI RES THORAX

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 31.
Female Adults: Scanner 4: HI RES THORAX

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 32.
Male Adults: Scanner 1: HI RES THORAX

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 33.
Male Adults: Scanner 2: HI RES THORAX

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 34.
Male Adults: Scanner 3: HI RES THORAX

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 35.
Male Adults: Scanner 4: HI RES THORAX

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 36.
Female Adults: Scanner 1: ABDOMEN / PELVIS

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 37.
Female Adults: Scanner 2: ABDOMEN / PELVIS

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 38.
Female Adults: Scanner 3: ABDOMEN / PELVIS

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 39.
Female Adults: Scanner 4: ABDOMEN / PELVIS

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 40.
Male Adults: Scanner 1: ABDOMEN / PELVIS

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 41.
Male Adults: Scanner 2: ABDOMEN / PELVIS

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 42.
Male Adults: Scanner 3: ABDOMEN / PELVIS

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 43.
Male Adults: Scanner 4: ABDOMEN / PELVIS

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 44.
Female Adults: Scanner 1: THORAX / ABDOMEN / PELVIS

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 45.
Female Adults: Scanner 2: THORAX / ABDOMEN / PELVIS

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 46.
Female Adults: Scanner 3: THORAX / ABDOMEN / PELVIS

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 47.
Female Adults: Scanner 4: THORAX / ABDOMEN / PELVIS

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 48.
Male Adults: Scanner 1: THORAX / ABDOMEN / PELVIS

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 49.
Male Adults: Scanner 2: THORAX / ABDOMEN / PELVIS

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 50.
Male Adults: Scanner 3: THORAX / ABDOMEN / PELVIS

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 51.
Male Adults: Scanner 4: THORAX / ABDOMEN / PELVIS

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 52.
Female Adults: Scanner 1 KUB

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 53.
Female Adults: Scanner 2 KUB

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 54.
Female Adults: Scanner 3 KUB

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 55.
Female Adults: Scanner 4 KUB

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 56.
Male Adults: Scanner 1: KUB

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 57.
Male Adults: Scanner 2: KUB

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 58.
Male Adults: Scanner 3: KUB

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 59.
Male Adults: Scanner 4: KUB

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 60.
Female Adults: Scanner 1: CTPA

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 61.
Female Adults: Scanner 2: CTPA

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 62.
Female Adults: Scanner 3: CTPA

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 63.
Female Adults: Scanner 4: CTPA

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 64.
Male Adults: Scanner 1: CTPA

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 65.
Male Adults: Scanner 2: CTPA

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 66.
Male Adults: Scanner 3: CTPA

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 67.
Male Adults: Scanner 4: CTPA

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 68.
Female Adults: OTHER

Please state name of Exam:

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 69.
Male Adults: OTHER

Please state name of Exam:

Number of Exams

Median CTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 70.
Female Adults: OTHER

Please state name of Exam:

Number of Exams

MedianCTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 71.
Male Adults: OTHER

Please state name of Exam:

Number of Exams

MedianCTDIvol (mGy)

Median DLP (mGycm)

Question Title

* 1. Name of Organisation:

Question Title

* 2. EPA Licence Number:

Question Title

* 3. Contact for Clinician with responsibility for radiation safety of the patient in CT, if different from the Practitioner in Charge:

Question Title

* 4. Contact details of person submitting information:

Question Title

* 5. CT Scanner Details:

Question Title

* 6. CT Scanner Details:

Question Title

* 7. CT Scanner Details:

Question Title

* 8. CT Scanner Details:

Question Title

* 9. State the total Number of CT Patients per Annum scanned in 2016:

Question Title

* 10. Do you Scan:

Question Title

* 11. Does your Dose Data get transferred automatically to your PACS?

Question Title

* 12. Female Adults: Scanner 1: BRAIN

Question Title

* 13. Female Adults: Scanner 2: BRAIN

Question Title

* 14. Female Adults: Scanner 3: BRAIN

Question Title

* 15. Female Adults: Scanner 4: BRAIN

Question Title

* 16. Male Adults: Scanner 1: BRAIN

Question Title

* 17. Male Adults: Scanner 2: BRAIN

Question Title

* 18. Male Adults: Scanner 3: BRAIN

Question Title

* 19. Male Adults: Scanner 4: BRAIN

Question Title

* 20. Female Adults: Scanner 1: CERVICAL SPINE

Question Title

* 21. Female Adults: Scanner 2: CERVICAL SPINE

Question Title

* 22. Female Adults: Scanner 3: CERVICAL SPINE

Question Title

* 23. Female Adults: Scanner 4: CERVICAL SPINE

Question Title

* 24. Male Adults: Scanner 1: CERVICAL SPINE

Question Title

* 25. Male Adults: Scanner 2: CERVICAL SPINE

Question Title

* 26. Male Adults: Scanner 3: CERVICAL SPINE

Question Title

* 27. Male Adults: Scanner 4: CERVICAL SPINE

Question Title

* 28. Female Adults: Scanner 1: HI RES THORAX

Question Title

* 29. Female Adults: Scanner 2: HI RES THORAX

Question Title

* 30. Female Adults: Scanner 3: HI RES THORAX

Question Title

* 31. Female Adults: Scanner 4: HI RES THORAX

Question Title

* 32. Male Adults: Scanner 1: HI RES THORAX

Question Title

* 33. Male Adults: Scanner 2: HI RES THORAX

Question Title

* 34. Male Adults: Scanner 3: HI RES THORAX

Question Title

* 35. Male Adults: Scanner 4: HI RES THORAX

Question Title

* 36. Female Adults: Scanner 1: ABDOMEN / PELVIS

Question Title

* 37. Female Adults: Scanner 2: ABDOMEN / PELVIS

Question Title

* 38. Female Adults: Scanner 3: ABDOMEN / PELVIS

Question Title

* 39. Female Adults: Scanner 4: ABDOMEN / PELVIS

Question Title

* 40. Male Adults: Scanner 1: ABDOMEN / PELVIS

* 11.
Does your Dose Data get transferred automatically to your PACS?

* 12.
Female Adults: Scanner 1: BRAIN

* 13.
Female Adults: Scanner 2: BRAIN

* 14.
Female Adults: Scanner 3: BRAIN

* 15.
Female Adults: Scanner 4: BRAIN

* 16.
Male Adults: Scanner 1: BRAIN

* 17.
Male Adults: Scanner 2: BRAIN

* 18.
Male Adults: Scanner 3: BRAIN

* 19.
Male Adults: Scanner 4: BRAIN

* 20.
Female Adults: Scanner 1: CERVICAL SPINE

* 21.
Female Adults: Scanner 2: CERVICAL SPINE

* 22.
Female Adults: Scanner 3: CERVICAL SPINE

* 23.
Female Adults: Scanner 4: CERVICAL SPINE

* 24.
Male Adults: Scanner 1: CERVICAL SPINE

* 25.
Male Adults: Scanner 2: CERVICAL SPINE

* 26.
Male Adults: Scanner 3: CERVICAL SPINE

* 27.
Male Adults: Scanner 4: CERVICAL SPINE

* 28.
Female Adults: Scanner 1: HI RES THORAX

* 29.
Female Adults: Scanner 2: HI RES THORAX

* 30.
Female Adults: Scanner 3: HI RES THORAX

* 31.
Female Adults: Scanner 4: HI RES THORAX

* 32.
Male Adults: Scanner 1: HI RES THORAX

* 33.
Male Adults: Scanner 2: HI RES THORAX

* 34.
Male Adults: Scanner 3: HI RES THORAX

* 35.
Male Adults: Scanner 4: HI RES THORAX

* 36.
Female Adults: Scanner 1: ABDOMEN / PELVIS

* 37.
Female Adults: Scanner 2: ABDOMEN / PELVIS

* 38.
Female Adults: Scanner 3: ABDOMEN / PELVIS

* 39.
Female Adults: Scanner 4: ABDOMEN / PELVIS

* 40.
Male Adults: Scanner 1: ABDOMEN / PELVIS

* 41.
Male Adults: Scanner 2: ABDOMEN / PELVIS

* 42.
Male Adults: Scanner 3: ABDOMEN / PELVIS

* 43.
Male Adults: Scanner 4: ABDOMEN / PELVIS

* 44.
Female Adults: Scanner 1: THORAX / ABDOMEN / PELVIS

* 45.
Female Adults: Scanner 2: THORAX / ABDOMEN / PELVIS

* 46.
Female Adults: Scanner 3: THORAX / ABDOMEN / PELVIS

* 47.
Female Adults: Scanner 4: THORAX / ABDOMEN / PELVIS

* 48.
Male Adults: Scanner 1: THORAX / ABDOMEN / PELVIS

* 49.
Male Adults: Scanner 2: THORAX / ABDOMEN / PELVIS

* 50.
Male Adults: Scanner 3: THORAX / ABDOMEN / PELVIS

* 51.
Male Adults: Scanner 4: THORAX / ABDOMEN / PELVIS

* 52.
Female Adults: Scanner 1 KUB

* 53.
Female Adults: Scanner 2 KUB

* 54.
Female Adults: Scanner 3 KUB

* 55.
Female Adults: Scanner 4 KUB

* 56.
Male Adults: Scanner 1: KUB

* 57.
Male Adults: Scanner 2: KUB

* 58.
Male Adults: Scanner 3: KUB

* 59.
Male Adults: Scanner 4: KUB

* 60.
Female Adults: Scanner 1: CTPA

* 61.
Female Adults: Scanner 2: CTPA

* 62.
Female Adults: Scanner 3: CTPA

* 63.
Female Adults: Scanner 4: CTPA

* 64.
Male Adults: Scanner 1: CTPA

* 65.
Male Adults: Scanner 2: CTPA

* 66.
Male Adults: Scanner 3: CTPA

* 67.
Male Adults: Scanner 4: CTPA

* 68.
Female Adults: OTHER

* 69.
Male Adults: OTHER

* 70.
Female Adults: OTHER

* 71.
Male Adults: OTHER