Congress:
EuroSafe Imaging 2016
Keywords:
Action 8 - EuroSafe Imaging Stars network and data collection, Action 3 - Optimisation, diagnostic reference levels, image quality, Action 2 - Clinical audit, Action 6 - Clinical audit tool for imaging, Action 2 - Clinical diagnostic reference levels (DRLs), Action 10 - EuroSafe Imaging Stars
Authors:
K. Ahlström Riklund, J. S. Andersson, J. Lundman, C. Granberg
DOI:
10.1594/esi2016/ESI-0035
Conclusion and Recommendations
VLL has used the Sectra DoseTrack radiation exposure monitoring IT-solution since October 2014.
Since then,
34 different X-ray units have been connected to the service and DICOM metadata associated with approximately 170 000 examinations and interventional procedures have been recorded.
Sectra DoseTrack offers a robust infrastructure for collecting DICOM metadata and presenting macroscopic information on radiation exposure levels,
which may be used to improve the processes of justification and optimization for healthcare providers.
It is clear that the focus of developing Sectra DoseTrack has so far been to elaborate the possibilities to use the data for optimization of radiation exposure.
While follow-up of data that can be used for evaluating justification is certainly possible at present,
it requires too much manual work to be a feasible tool.
From the perspectives of both radiation protection and quality control in radiology,
it would be beneficial to incorporate information from RIS and PACS pertinent to questions of justification into radiation exposure monitoring IT-solutions.
Even more robust and automated follow-up of justification may be achieved by incorporating appropriateness criteria in future IT-solutions.
A substantial incentive for healthcare providers to adopt a radiation exposure monitoring IT-solution comes from national legal requirements from radiation safety authorities on reporting statistics associated with X-ray radiation exposure levels.
From the experience in VLL,
Sectra DoseTrack is not well suited for such applications due to gaps between information presently available and demands on reporting exposure levels for a standardized,
rather than a typical,
patient for a given examination type.
This is something that is likely true for all vendors of radiation exposure monitoring IT-solutions that are not integrated with the main patient journal system for a given healthcare provider.
Beyond system integration,
a further development of the DICOM standard could solve this issue.
However,
a more robust solution would be to adopt attenuation based patient size metrics and merge them with radiation exposure levels,
e.g.
as for the SSDE in CT applications.
The emergence of enterprise solutions for radiation exposure monitoring in radiology can be considered as a recent occurrence,
and such IT-solutions can be expected to mature and evolve drastically in the coming years.
The academic and open source communities,
together with organizations working on standardization,
can also be expected to play important roles in this evolution for the benefit of global radiation protection and quality assurance in radiology.