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Article History

Received: 22 November 2024

Revised: 12 September 2025

Accepted: 24 October 2025

First Online: 24 November 2025

Compliance with ethical standards

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: The scientific guarantor of this publication is Dr. Rebecca Smith-Bindman.

: Dr. Smith-Bindman is a co-founder and Dr. Timothy Szczykutowicz is a consultant of Alara Imaging, Inc., a new company focused on improving the clinical and operational aspects of health systems, including collecting and reporting CT radiation dose and image quality as part of payer-led quality programs. Alara Imaging had no role in the study, and Dr. Smith-Bindman has not received funding from Alara Imaging. The other authors have no conflicts to disclose.

: Dr. Taewoon Kang performed all statistical analyses for this study, with biostatistical consultation from Mr. Philip Chu and Dr. Yifei Wang.

: The UCSF International CT Dose Registry (from which this work derived) was approved by the UCSF Institutional Review Board with a waiver of informed consent for all subjects. The waiver was approved for three reasons: the attempt to contact subjects poses a greater risk than this study; the large number of records required makes it impracticable to contact all potential subjects; and the researchers do not know the identity of the study subjects and therefore cannot contact them.

: Institutional Review Board approval was obtained.

: As these data come from a CT radiation dose registry, some of the CT exams included in this study may be represented in previous publications, including the following: (1) Smith-Bindman et al [ ]; (2) Wang et al [ ]; (3) Smith-Bindman et al [ ]; (4) Smith-Bindman et al [ ].

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