Optimization Strategies in Non-Contrast Head CT Examinations for Patients Based on The Role of Radiographers and Clinical Protocols: A Literature Review
DOI:
https://doi.org/10.53770/amhj.v5i3.738Keywords:
Non-Contrast Head CT, Optimization, Radiographer Role, Clinical ProtocolsAbstract
Non-contrast head computed tomography (CT) examinations are associated with a potential risk of unnecessary radiation exposure when optimization principles are not consistently applied in clinical practice. Radiographers play a pivotal role in implementing appropriate clinical protocols to ensure patient radiation safety without compromising diagnostic image quality. This study aimed to review optimization strategies for non-contrast head CT examinations with a particular focus on the role of radiographers and clinical protocols. Literature review was conducted using articles retrieved from the PubMed database published between 2020-2025. The selected studies were analyzed descriptively by examining study characteristics, optimization approaches, and their implications for clinical radiography practice of non-contrast head CT examination. The results indicate that optimization of non-contrast head CT can be achieved through appropriate adjustment of technical parameters by radiographers, application of iterative reconstruction techniques, minimization of patient positioning errors in anteroposterior, posteroanterior, and lateral orientations, use of eye shielding combined with tube current modulation (TCM), and implementation of diagnostic reference levels (DRLs) based on clinical indications. In addition, regular radiographer training contributes to the consistent application of optimization strategies. In conclusion, effective optimization of non-contrast head CT examinations requires an integrated approach that combines radiographer competency and evidence-based clinical protocols to minimize patient radiation exposure while maintaining diagnostic image quality.
References
Albalawi, A. N. A., Albalawi, A. H., Alqahtani, N. S., Alharbi, N. S. O., Albalawi, M. Z. A., Aletewi, N. A., … Al-Harbi, G. A. D. (2024). Efficiency optimization for operation technicians in radiology and imaging departments: A review study of strategies, factors influencing, challenges, current roles, responsibilities, and future directions. Journal of International Crisis and Risk Communication Research, 7(S11), 2253. https://doi.org/10.63278/jicrcr.vi.1581
Alotaibi, A. M., Alyahiwi, I. M., Albathan, S. N., Alharbi, F. R., Alosimy, M. H., Alrowily, R. H., … Alanazi, F. A. (2024). Impact of CT imaging in emergency medicine. Journal of International Crisis and Risk Communication Research, 7(S11), 1663–1681. https://doi.org/10.63278/jicrcr.vi.1466
Bos, D., Guberina, N., Zensen, S., Opitz, M., Forsting, M., & Wetter, A. (2023). Radiation exposure in computed tomography. Deutsches Ärzteblatt International, 120(9), 135–141. https://doi.org/10.3238/arztebl.m2022.0395
Delios, A., Clemente, E. G., Wu, T., Tan, H., Wang, Y., Gordon, M., … Uhlmann, E. L. (2022). Examining the generalizability of research findings from archival data. Proceedings of the National Academy of Sciences, 119(30), e2120377119. https://doi.org/10.1073/pnas.2120377119
Devery, C., Cody, D., & Sweetman, L. (2025). Evaluation of workload distribution and exposure factors in common use in ten general X-ray rooms in Ireland: An initial step towards protocol optimisation. Radiography, 31(1), 419–425. https://doi.org/10.1016/j.radi.2024.12.021
Dieckmeyer, M., Sollmann, N., Kupfer, K., Löffler, M. T., Paprottka, K. J., Kirschke, J. S., & Baum, T. (2023). Computed tomography of the head: A systematic review on acquisition and reconstruction techniques to reduce radiation dose. Clinical Neuroradiology, 33(3), 591–602. https://doi.org/10.1007/s00062-023-01271-5
Diener, E., Northcott, R., Zyphur, M. J., & West, S. G. (2022). Beyond experiments. Perspectives on Psychological Science, 17(4), 1101–1119. https://doi.org/10.1177/17456916211037670
Gohla, G., Örgel, A., Klose, U., Brendlin, A., Bongers, M. N., Bender, B., Staber, D., Ernemann, U., Hauser, T.-K., & Ruff, C. (2025). Comparison of ADMIRE, SAFIRE, and filtered back projection in standard and low-dose non-enhanced head CT. Diagnostics, 15(12), 1541. https://doi.org/10.3390/diagnostics15121541
Kosaka, H., Monzen, H., Amano, M., Tamura, M., Hattori, S., Kono, Y., & Nishimura, Y. (2020). Radiation dose reduction to the eye lens in head CT using tungsten functional paper and organ-based tube current modulation. European Journal of Radiology, 124, 108814. https://doi.org/10.1016/j.ejrad.2020.108814
McCollough, C. H., Chen, G. H., Kalender, W., Leng, S., Samei, E., Taguchi, K., Wang, G., Yu, L., & Pettigrew, R. I. (2012). Achieving routine submillisievert CT scanning: Report from the summit on management of radiation dose in CT. Radiology, 264(2), 567–580. https://doi.org/10.1148/radiol.12112265
Mettler, F. A., Huda, W., Yoshizumi, T. T., & Mahesh, M. (2008). Effective doses in radiology and diagnostic nuclear medicine: A catalog. Radiology, 248(1), 254–263. https://doi.org/10.1148/radiol.2481071451
Najjar, R. (2024). Clinical applications, safety profiles, and future developments of contrast agents in modern radiology: A comprehensive review. iRadiology, 2(5), 430–468. https://doi.org/10.1002/ird3.95
Özsoykal, İ., Yurt, A., & Akgüngör, K. (2018). Size-specific dose estimates in chest, abdomen, and pelvis CT examinations of pediatric patients. Diagnostic and Interventional Radiology, 24(4), 243–249. https://doi.org/10.5152/dir.2018.17450
Ramazan, F., Aarts, S., & Widdowfield, M. (2022). Exploring the implementation of evidence-based optimisation strategies: A qualitative study of the experience of diagnostic radiographers. Radiography, 28(3), 804–810. https://doi.org/10.1016/j.radi.2022.02.003
Ravenscroft, L., & Baker, L. (2024). The influence of miscentering on radiation dose during computed tomography head examinations and the role of localiser orientation: A phantom study. Radiography, 30(6), 1517–1523. https://doi.org/10.1016/j.radi.2024.09.051
Rusmanto, R., & Kunarsih, E. (2024). Dosis efektif kolektif dari penggunaan radiasi untuk medis di Indonesia: Studi data Si-INTAN periode 2018–2021. Jurnal Pengawasan Tenaga Nuklir, 4(1), 44–50. https://doi.org/10.53862/jupeten.v4i1.006
Singh, S., Kalra, M. K., Moore, M. A., Shailam, R., Liu, B., Toth, T. L., Grant, E., & Westra, S. J. (2009). Dose reduction and compliance with pediatric CT protocols adapted to patient size, clinical indication, and number of prior studies. Radiology, 252(1), 200–208. https://doi.org/10.1148/radiol.2521081554
Smith-Bindman, R., Lipson, J., Marcus, R., Kim, K. P., Mahesh, M., Gould, R., Berrington de González, A., & Miglioretti, D. L. (2009). Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Archives of Internal Medicine, 169(22), 2078–2086. https://doi.org/10.1001/archinternmed.2009.427
Tan, W. S., Foley, S., & Ryan, M. L. (2023). Investigating CT head diagnostic reference levels based on indication-based protocols: A single site study. Radiography, 29(4), 786–791. https://doi.org/10.1016/j.radi.2023.05.003
Tarkiainen, J., Nadhum, M., Heikkilä, A., Rinta-Kiikka, I., & Joutsen, A. (2023). Radiation dose of the eye lens in CT examinations of the brain in clinical practice: The effect of radiographer training to optimise gantry tilt and scan length. Radiation Protection Dosimetry, 199(5), 391–398. https://doi.org/10.1093/rpd/ncad002
Tresker, S. (2022). Treatment effectiveness, generalizability, and the explanatory/pragmatic-trial distinction. Synthese, 200, 316. https://doi.org/10.1007/s11229-022-03517-0
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Ahmar Metastasis Health Journal

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.



