The results point to a prevalence of positive aspects, rather than disadvantages of implementing DMS. Some of the strengths highlighted include: ^{1,5,6,7,8,9,10,11}

• Rapid collection and reliable management of CT dose data
• Single database
• Assessment of a whole sample and not only a limited number of patients
• Easy and quick statistical overview of all clinical and technical data
• Collection of dosimetric data to establish local and/or national DRLs
• Checking compliance with established DRLs
• Detection, identification and alert generation of high dose levels or overexposures
• Optimization of patient’s exposure, especially in computed tomography and interventional radiology which are the two modalities that require higher levels of dose exposure
• Assessment and implementation of corrective actions in determined protocols
• Fast reviewing of the examinations and quick actions to be taken to reduce patient dose
• Improvement of workload, personal efficiency, and patient dose exposure assessment
• Estimation of effective dose and organ doses
• Collaboration of radiographers and radiologists to change protocols and practices towards dose reduction
• Structured consolidation of dose documentation, reporting and tracking
• Data centralization for all imaging modalities performed in the RD facilitates dose auditing.

Some disadvantages of DMS were also identified, namely: ^{1, 7}

• Dose management system acquisition and maintenance costs
• Expensive and limited access investment
• Inconstancy in the examination’s categorization due to differences on the DMS recommended protocols and the ones practiced in the RD.
• Need for definition of DRLs based on clinical indications since numerous protocols in RD are based on different examination justification for the same anatomical region to a achieve a more effective and accurate comparison of practice.

In summary, the findings point to a prevalence of positive aspects such as a single database, easier statistical data acquisition, and the alert generation in error/ outliers’ detection. Besides that, some of the major advantages are mainly the monitoring and comparison with national and international DRLs, image quality optimization and the creation of automatic dose reports. All those aspects were highlighted and reinforced in the BSSD. Besides, the whole implementation process is associated with acquisition and maintenance costs as well as the radiographer’s commitment in its configuration and operation. The most important positive and negative points drawn from this review are summarized in figure 1.

Fig 1: Figure 1- Pros and cons of implementing a Dose Management System in Radiology...