Congress:
EuroSafe Imaging 2020
Keywords:
Multicentre study, Observational, Retrospective, Patterns of Care, Screening, CT, Radiation physics, Lung, Action 2 - Clinical diagnostic reference levels (DRLs)
Authors:
M. B. Chatfield, D. Golden, D. Gress, M. Simanowith, J. Burleson
DOI:
10.26044/esi2020/ESI-14402
Background/introduction
There are ongoing efforts worldwide to develop Diagnostic Reference Levels (DRLs) and keep them updated [1-3]. One persistent challenge of this effort is to be able to gather accurate data with minimal burden of the providers. Automated data submission is often less burdensome than manual data collection, and could potentially be more accurate as it is not subject to human error associated with data entry. However, not all facilities and geographic regions have the right technology infrastructure to deliver the data in this format, and prefer to use manually extracted and submitted data, which may not be comparable to the automated data. There is no evidence that we are aware of that compares data collected manually and automatically in an overlapping population.
We look at a narrow slice of this problem using data in the US, to determine whether CT radiation dose indices captured automatically from DICOM objects result in meaningfully different results on DRLs than self-reported data captured manually or from other electronic health record systems. We focus on lung cancer screening CTs. Low dose CT (LDCT) lung screening data are well suited to this comparison because of the narrowly specified protocol and availability of data.
The American College of Radiology collects information on CTDIvol and DLP for low dose screening CTs in two registries. The Dose Index Registry (DIR) receives data on CT studies as DICOM objects – Radiation Dose Structured Reports (RDSRs) and secondary capture [4]. The Lung Cancer Screening Registry (LCSR) collects data on lung cancer screening studies through manual data entry, data uploads, and feeds from electronic health systems [5]. Participation in DIR is voluntary; LCSR participation is required for reimbursement from the federal Medicare program.