Radiation Dose Optimization in a Multicenter CCTA Program.

backgroundExcessive radiation exposure from coronary computed tomography angiography (CCTA) increases lifetime malignancy risk. Internal review within a 5-hospital health system revealed median system-wide doses above best-practice targets, with high intercampus variability. PROJECT RATIONALE: Dose optimization is a modifiable patient safety measure supported by national guidelines, with evidence that reduction can be achieved without loss of diagnostic quality. PROJECT SUMMARY: Implementation of standardized, evidence-based CCTA protocols across the health system reduced the median radiation dose from 6.2 millisievert (mSv) to 4.8 mSv (23% reduction) while improving diagnostic acceptance from 90.5% to 92.7% (P = 0.019). Improvements were consistent across campuses despite equipment variability and were sustained through ongoing monitoring, staff education, and leadership engagement. This initiative provides a scalable model for achieving ≤4 mSv best-practice targets in multicenter cardiovascular imaging programs. TAKE-HOME MESSAGES: Tracking radiation doses is imperative. Standardized, evidence-based protocols can achieve sustainable CCTA radiation dose reduction across diverse campuses without compromising diagnostic quality.