Quality initiative: Quantifying and reducing dose in multiphase liver CT: Eliminating the nonenhanced study and using conscientious Z-creep

The use of computed tomography (CT) for evaluation of liver disease has increased dramatically at our tertiary care center due to increased hepatology referrals. We sought to decrease the radiation dose associated with multiphase liver CT studies while maintaining a high degree of diagnostic accuracy. We found that by eliminating the nonenhanced acquisition and adjusting the imaging field of view to include the liver-containing abdomen only—simply by manipulation of patient-specific imaging parameters—we achieved a 30% reduction in dose.