Radiation Dose Reduction for Barium Enema: an Achievable Improvement in Patient Care

Objective: To evaluate the effectiveness and practicality of dose-reduction measures for double-contrast barium enema based on well-established UK National Reference Levels. Methods: Between May 2009 and February 2011, 369 patients were prospectively studied with respect to radiation doses received while undergoing double-contrast barium enema examinations before and after implementation of radiation dose-reduction measures. Statistical analysis was performed on fluoroscopic screening times, dose-area-product, and the number of undercouch and overcouch films used during the examination. Results: A significant reduction in fluoroscopic screening time (43%) was achieved after implementation of dose-reduction measures (p < 0.01). Similarly, a 40% reduction in dose-area-product was achieved at the end of the study (p < 0.01). Before the implementation of the dose-reduction measures, the mean dose-area-product and fluoroscopic screening time at our centre were at 73% and 58% above the UK National Reference Levels, respectively. At the end of the study, they were noted to be up to 13% lower than the UK standards. Conclusion: A 40% reduction in radiation dose on patients undergoing double-contrast barium enema was achieved after implementation of dose-reduction measures in our hospital. The double-contrast barium enema radiation dose was also reduced from 73% above the UK National Reference Level to a level below this reference standard.