Tavakoli Taba, AmirEkpo, ErnestKench, PeterALanazi, Mohammed2026-07-072026https://hdl.handle.net/20.500.14154/79448Aim: This thesis investigated the role of automated dose monitoring systems (DMS) in computed tomography (CT) radiation dose monitoring and optimisation. Method: A multi-method research design comprising two systematic reviews and three empirical studies was undertaken. The first review evaluated the use of DMS high-dose alert functions and their impact on CT dose optimisation, while the second examined DMS applications, benefits, and challenges in CT practice. The third study surveyed CT dose monitoring practices and DMS adoption in Australian radiology facilities. The fourth study explored the experiences of medical physicists and radiographers using DMS in CT. The final study retrospectively assessed a DMS's ability to detect high-dose CT events at an Australian radiology facility. Results: Study 1 showed that DMS systems are valuable for identifying high-dose events and supporting dose optimisation. Study 2 showed that DMS systems facilitate benchmarking, tracking and estimation, although challenges related to data inconsistencies and integration issues were reported. Study 3 found although most Australian radiology facilities performed CT dose assessments, these were commonly undertaken annually using traditional methods, and 41% used DMS. Study 4 showed that DMS users reported improved workflow efficiency, CT dose assessment, and radiation protection practices, although challenges related to system setup, data validation and IT infrastructure were identified. The final study found that 851 of 11,865 CT examinations (7%) triggered DMS alerts, most commonly in spine, joint, and abdomen–pelvis CT exams, with contributing factors related to patients and operators. Conclusion: Automated DMS systems support CT dose monitoring and optimisation through continuous dose assessment, benchmarking, and identification of high-dose events. Wider adoption, supported by appropriate implementation and training, would strengthen radiation protection and enhance patient safety.258enComputed TomographyCTAutomated Dose Monitoring SoftwareRadiation Monitoring SoftwareRadiation Dose ManagementRadiation ProtectionRadiation ReductionDose OptimisationDose AlertsDose NotificationsSurveyMedical PhysicistsRadiographersThesis