Congress:
EuroSafe Imaging 2020
Keywords:
Action 4 - Dose management systems, Computer applications, Radiation physics, Radioprotection / Radiation dose, Catheter arteriography, Conventional radiography, CT, Computer Applications-General, Radiation effects, Radiation safety, Quality assurance, Not applicable
Authors:
R. W. Loose, E. Vano, P. Mildenberger, V. Tsapaki, D. Caramella, J. Sjöberg, G. Paulo, A. Torresin, S. Schindera
DOI:
10.26044/esi2020/ESI-11078
Conclusion and recommendations
It was agreed that dosimetric input data for DMS should be only physical dose parameters delivered by the different modalities properly validated by a MPE. Depending on the workflow these data may either come directly from the modalities or with only one source via the PACS. Here, the WG will follow recommendations of the WG “Dosimetry for imaging in clinical practice”.
One topic initially selected by the WG was the classification of different DMS performance levels. A three level classification could be:
DMS minimal requirements:
- Use only physical device related DICOM dose parameters
- Should work with DR, (CR with DAP interface), MG, CT, RF, XA
- Get and store dose parameters from DICOM headers for all images, skip image data
- Translate local into standard protocol names (e.g. RadLex playbook)
- Set alert trigger levels (local and national)
- Export dose data for QA, reporting (e.g. to national authority) and post processing
DMS standard requirements (all above plus):
- Should work with all modalities above and all providing RDSR
- Store dose data in database e.g. with SQL-query
- Display dose charts as timeline for selected modalities and procedures
- Automatic reports to responsible professionals (radiologists, radiographers, MPE)
- Send alerts to above professionals on local / national events
DMS high-level solutions (all above plus):
- Calculation of effective dose for individual patients (not recommended by ICRP due to large uncertainties for several reasons)
- Calculation of organ doses (with high uncertainties)
- Report modality load (day, time, procedure)
- Include contrast media data
- Store and display cumulative patient dose
- Include occupational doses
It was agreed that there is a need for DMS which can be tailored to the size and workload of a clinic/institution. A large maximum care hospital has other requirements than as a small institution with one practitioner and one X-ray modality. It should be mentioned that large scale DMS require a significant staff work load, especially by MPEs.
DMS must be configurable to include national requirements, like DRL trigger levels. Challenges are criteria for detection and reporting of unintended exposures as there is a wide range of implementations of the EU-BSS into national law like absolute doses, multiples of DRLs, effective dose or just plain text (Fig. 4).